Liverpool care pathway

[stella1w]

Posting here for traffic, not debate,
distraught friend just told her mum, demented, at home with 24 hour care has been put on liverpool care pathway. She spoke to the gp about palliative care thinking it would mean a nursing home and was not consulted about lcp. Gp is refused to let her mum have sedatives or water and my friend is v v v upset and feels this is like euthanasia. She doesn,t seem to know what to do or if she has any rights to stop it. It could take four weeks.
I said if she had doubts she should ask for lcp to be postponed until the children had been consulted and undertood and consented.
What can she do?

[Sirzy]

oh dear, according to the group Cheryl linked to she is giving us "gyp" I must have missed that in amongst her childish posts.

[CherylAmber]

sirzy there you go again, ive lost ppl so i know what it feels like, jst stop tryin to justify yourself all the time coz you know that every case is different and ppl can live a long time without food, but not for that long without water. but then maybe this is more about budgets and money, than real care :(

Either way the lcp is bad practice, too many cases have happened where it has gone wrong with lives just put down to mistakes :/

[CherylAmber]

sirzy so what Im only 17 and do you think im that flustered abt what you think

[VinegarDrinker]

You might think that those of us who do actually care for dying patients have some inkling of what makes them comfortable. But no, we are just following some sinister sounding "Master Plan", not wanting the best for our patients/relatives ... righty ho.

Because the NHS benefits from the LCP erm, how exactly?

Anyway, I'm out.

[Sirzy]

it is EVERYTHING to do with making things more comfortable for people. I really suggest if this is an area that intersts you which it obviously does you make the effort to research it properly and not just believe the crap information from one side of the argument.

[Sirzy]

Debating isn't about getting your own way though Cheryl, thats what you seem to be unable to understand. You are posting your view but then getting very flustered when people are posting factual information which brings what your saying into doubt.

[CherylAmber]

who said nhs benefits from lcp? mind you there was something abt there being financial incentives but who knows they are your words not mine, perhaps it comes down to beds or something...

[VinegarDrinker]

Just before I go, do you think you know how to do the entire of my job better than I do, or is it just palliative care you're an expert in? I'd love to know as I'm just wondering why I wasted those years of studying and actually doing the job.

How about going and doing some work experience on an elderly care ward or in a hospice, and then train as a nurse or doctor to combat all these evil types with a sinister master plan?

[lustybusty]

stella my gma was (I think) on LCP with terminal cancer when we begged for her to be discharged from hospital to care for her at home. My dad and I were taight/shown by a nurse how to lift her on and off a commode safely, a team came round to make sure her bed was comfy, but most tellingly to me, the consultants exact words were "give her what she wants, when she wants, to the best of your ability". Hence her last drink on earth was a sip of gin and tonic out of a toddler sippy cup, washed down with a spoonful of oramorph. That's what she wanted, that's what she got. The only medical intervention she had was when we asked for her to be catheterised as we were hurting her when we lifted her. THAT, to me, is what the LCP is all about - not witholding stuff, quite the opposite. Hope your friend can talk to gp, explaining that her mum deserves, at the VERY least, to doe in comfort.

[Sirzy]

And if they want a drink they get one. It really is that simple!

[BetteDavis01]

My nan is currently in hospital and I think, she doesn't have much longer left, the nurses seem to think that as well. Nan doesn't want to eat anything and just sips a tiny bit of water. She is fading away, it's as if nature as taken over. She is withdrawing from life.

I read the Daily Mail and when I first read about LCP, I was horrified. Last weekend a nurse explained it to me, and I now want my Nan to be placed on it, when the time comes.

IMO, LCP, lets nature take its course but makes the person comfortable and allows them their dignity.

[Sirzy]

Lusty Sorry to hear about your Grandma but pleased she got a comfortable death (for want of a better way of describing it)

Sounds very similar to my Grandfather, the last thing he wanted was a whiskey! He would have hated being in a hospital being forced to have treatment which is what people seem to forget, this is about what is best for the person who is dying and in a lot of cases invasive treatment isn't what is best.

[GurlwiththeFrothyCurl]

My DM died a few months ago. For her last three days she was put on the LCP with our consent. The nursing staff were wonderful and she eased her way from this life with comfort and dignity. None of us have any issues with the LCP. It was humane and kind.

[mrsbunnylove]

good grief. i can't read this squabbling.

my mum was on the lcp a couple of months ago and the government saved her life by saying patients can't be put on it without family permission. they didn't have our permission. she's alive and relatively well. she had eight out of ten stages of death when she was in hospital and only a day or two more dehydration to go before the end. i think family consent might be part of it now, and is something to ask about.

[JugglingFromHereToThere]

As someone who doesn't know that much about the Liverpool Care Pathway and what is included (though have just learnt more in this thread) - but am in favour of good palliative end of life care and don't feel life should be prolonged at any cost - am just not sure that calling care "The Liverpool Care Pathway" is that helpful. Doesn't it just make it more mysterious to people ? (other than HCP's who know what it includes) I think talking more plainly about "end of life care" or "palliative care", if people have heard of that, might be better.

I'm sorry to hear your friend is concerned/ upset about her mother's care - I'm sure seeking other medical opinions would be good.

[hatgirl]

Cheryl aren't you too young to be reading the daily mail?

Most young people I come across have very open minds and don't believe everything they read in the papers. It is one of the great aspects of youth - take advantage of it while you still can.

Perhaps the people who would like to have a reasonable, adult discussion about a very serious topic would like to continue, I suggest Cheryl that if you want your views to be taken seriously you stop using text speak and stop being agressive towards other posters. Otherwise people will just start to ignore your posts (if they don't get deleted!) Up to you....

[hellhasnofurylikeahungrywoman]

CherylAmber-where does your fear of the LCP come from, personal experience or is it just what you've read?

[lustybusty]

sirzy thanks, it's what she (and us) wanted- to due in peace, in bed, in the house she lived in all her married life. I agree with the people forgetting what's best for the patient, the week she died, had she still been in hospital, she would probably have had her THIRD camera up bum (colonoscopy?) in three months... They'd already diagnosed terminal cancer and advised against treatment, so why keep on with the (uncomfortable, undignified) investigations?!?

[Lifeisontheup]

The LCP is not necessarily a permanent state, people can go on and off it if their condition changes.
If used properly then it can provide a gentle passing, google Dr Kate Granger if you want a balanced intelligent discussion of it from someone who is not only a Doctor but also terminally ill.

[lustybusty]

And cheryl I believe gma WAS ON LCP... what we did for her was keep her happy and comfortable-which is what I think LCP is meant to be about (if you ignore the daily mail hysteria about a couple of drs/hospitals getting it wrong...)

[SantasHairyBollock]

LCP is essentially what used to be called providing TLC. tender loving care, plus common sense. Relieving pain/symptoms as much as possible but not trying to cure when death seems inevitable.

Pain relief or sedation if needed, and as far as water etc goes - typically a person with impaired swallowing reflex would not be allowed oral fluids(unless thickened at least, as it may cause pneumonia) If it's recognised that the patient is clearly dying then you would allow oral fluids if they wanted them, because possible side effects don't matter in this situation. Dignity and comfort matter.

I would be happy for my loved ones to be cared for in this way, very happy. Much rather that than the alternative.