Case study:

11 May 2010

Improving end of life care for individuals with dementia in the North West

Key points

Five pilot sites in Greater Manchester and the North West are implementing the Gold Standard Framework for care homes for people with dementia.

The pilots involve four independent sector care homes and one mental health trust, spread across four PCTs.

Staff in each pilot site receives extensive training to help residents stay in their preferred place of care.

Support is also extended to families, friends and staff themselves.

Each site has set up a working party and has monthly GSF meetings to discuss residents with palliative care needs and consider anticipatory planning and prescribing.

There is also an opportunity for reflective practice and education.

NHS Northwest, which is running the pilots, has faced a number of challenges along the way.

Some training sessions have been poorly attended, for example, which meant extra training had to be organised.

It is also difficult to maintain the momentum when staff face so many other pressures on their time.

It has not always been possible to persuade GPs to prescribe in advance. And the cultural and spiritual differences within teams meant some staff had very different attitudes to death.

All now recognise that their beliefs should not affect how they deal with a resident’s death as everyone will have a different path to take.