Services Stretched As Palliative Carers Are Struggling To Cope

End-of-life care is changing in Scotland. Eight years ago, the Marie Curie home nursing service would visit a maximum of 15 patients a night.

End-of-life care is changing in Scotland. Eight years ago, the Marie Curie home nursing service would visit a maximum of 15 patients a night. Today their staff can call on 65 to 70 people in one evening, helping them cope with their remaining days.

Maggie White, care services manager for Marie Curie, said: “Once a patient is referred into Marie Curie we can take care of their physical needs, psychological needs and practical needs as well.”

Spending time in a hospice can be part of that support package. Some people’s needs are too complicated to be dealt with at home and efforts are made to provide a supportive environment.

However, with the recognition hospital beds are not the best place to spend long periods of time, the emphasis on home care is growing. Scotland’s politicians appear to support this move.

A survey by Marie Curie found three-quarters of MSPs would choose to die at home themselves and felt the Scottish Government should pay for patients to do so. However, the reality is very different – with less than a quarter of people fulfilling this wish.

Dr David Jeffrey, consultant in palliative care at Borders General Hospital, said: “I think if someone is on their own at home, logistics of providing round-the-clock care is increasingly difficult. There are difficulties in finding carers to give care and families become exhausted and cannot cope.”

He said end-of-life care workers had been employed on short-term contracts in the past and paid poorly so, in the Borders at least, they were difficult to find.

Perhaps because death is still a taboo subject in Scottish society, he and others argue terminal care does not benefit from large funding streams or political priority.

On Wednesday, the Royal College of Physicians of Edinburgh is holding a symposium on end of life issues. A college spokesman said: “Palliative care medicine is an area in which extensive medical training is required.

“Such new technological advances, medical training and staffing do not come without cost to the NHS, and those working within palliative care would support any political calls for an increase in dedicated resources.”