Introduction by Professor Marcus Longley, Director of WIHSC and Professor of Applied Health Policy
In this week’s blog in our ‘20 blogs for 20 years series’, to mark the Institute’s 20th anniversary, Professor Siobhan McClelland reflects on an intensely personal experience to ask whether the NHS has yet got the end of life right for everyone. Siobhan is an External Professor at the Institute and is Vice Chair of Aneurin Bevan University Health Board, and has experience and insight across an exceptionally wide range of health policy areas. End-of-life care remains one of the most problematic areas for the NHS and social care, and has added relevance in an era of Prudent care.
A good death?
For most of her life my grandmother rarely troubled the NHS. From a sheep farming family in the Rhymney Valley she remembered life before the NHS. She wasn’t a big supporter of Nye Bevan “I always vote Liberal” but she valued his creation although she was fortunate to not need to use it much.
Until the last two years of her life … over one hot summer she developed a UTI and was admitted to hospital. Whilst the hospital was committed to treating her and getting her home as quickly as possible this began a rotating door of hospital admissions, GP visits and increasingly complex medication. She lived independently in sheltered housing but became increasingly more dependent on my mother for day to day care and support. She often fell and started to feel scared in her own home but determined not to leave it.
Following a fall during the Christmas period the paramedics took her yet again to the hospital. Before New Year in the early hours of the morning my mother received ‘the call’ to come to the hospital. She wandered the deserted site in her distress trying to find an open door. When she got to the ward she found my grandmother had died before she could get there to say goodbye.
My grandmother was 95. She had a good innings to use that rather unhelpful cricket analogy. There are lots of points to make about polypharmacy, integrated care and prudent healthcare and of course about our quality of life particularly in our later years. This didn’t happen in Wales but it could have and I know that many other people have similar stories to tell.
What remains with me though is that my nana died in a hospital quite possibly alone and certainly without her family around her. So while on this twenty year anniversary of WIHSC where we talk much of how we want to live we also need to talk about how we want to die.
Siobhan McClelland, External Professor USW and Vice Chair of Aneurin Bevan University Health Board