BMJ  2007;334:599 (24 March), doi:10.1136/bmj.39156.518461.FA

Letters

A good death

We need a mix of care in the NHS

I have a similar story to Newton's about the death of my father last year.¹ He was 78 and for more than 20 years had seen his mobility and independence slowly eroded by multiple sclerosis. He developed a chest infection over Christmas but had strongly protested his desire to stay at home, which became impossible as pressure sores developed.

The first 11 weeks were spent in an acute medical ward. The doctors actively treated him with intravenous antibiotics, insulin infusions for diabetes, and a nasogastric tube. The emphasis was on "getting him better" so he continued to receive unpleasant active intervention despite my remonstrations that palliative care was much more appropriate. His complex illness improved, but he could not eat or look after himself: the ward was busy and he was in the wrong place. He became withdrawn and unresponsive. His pressure sores continued to get worse, and he became confused.

The last seven weeks were spent in a hospital which specialised in helping people with long term debilitating illness. Here the staff actively treated my father as a person, not as a complex medical puzzle. He was washed and shaved caringly every day; he had a haircut and had his nails trimmed. He was patiently given the type of food he was fond of. The staff sat with him and talked about his and their lives, and his confusion lifted. His pressure sores started to heal. In June he had a stroke, and he died without regaining consciousness over four days. The staff let us stay with him while he was dying and looked after us.

Both hospitals treated my father well but met different needs. The second hospital is now threatened with closure because funding is not available. We should not dispense with this type of care because targets and tariffs concentrate funding on the acute sector.

Meddygfa Gyffin, Conwy LL32 8LT

---

Competing interests: None declared.

References

1. Newton P. A good death—but no thanks to the NHS. BMJ 2007;334:536. (10 March.)[Free Full Text]

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Articles

Potential of electronic personal health records

Claudia Pagliari, Don Detmer, and Peter Singleton
BMJ 2007 335: 330-333. [Extract] [Full Text] [PDF]

A good death—but no thanks to the NHS

Paula Newton
BMJ 2007 334: 536. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Pagliari, C., Detmer, D., Singleton, P. (2007). Potential of electronic personal health records. BMJ 335: 330-333 [Full text]