More hospices needed ‘to care for people dying gradually’

More hospices and care homes are needed to cope with increasing numbers of people dying “gradual” deaths, say doctors.

Better health care, and to some extent a fitter older population, means fewer people are experiencing ‘sudden’ deaths, for example from heart attacks.

By Stephen Adams, Medical Correspondent

7:30AM BST 18 Sep 2012

The country faces a growing crisis in its ability to care for people suffering cancer, dementia and other long-term ailments, according to specialists who say that supply is not keeping pace with demand.

Better health care, and to some extent a fitter older population, means fewer people are experiencing “sudden” deaths, for example from heart attacks.

While increased longevity is to be welcomed, doctors say not enough resources are being devoted to making the last days of the elderly as comfortable as possible. Doctors writing in the British Medical Journal Supportive and Palliative Care say gradual deaths from cancer and other chronic diseases are already “a considerable burden” for European countries.

They say health planners need to look at improving end-of-life care, particularly for those not suffering from cancer.

Dr Martin Vernon, a spokesman for the British Geriatrics Society, said care must improve for elderly people with other diseases, particularly dementia.

“Right now we are looking at rises in demand resulting from all sorts of long-term conditions, not just cancer,” he said. “We are talking about heart failure and particularly dementia.

“Improvements in treatment of dementia over the last decade have improved prognosis. But that means there needs to be an increase in care and support, both for those living at home, and for those in formalised care settings.”

Care homes were too often “not geared up for modern palliative care”, he said, particularly for those with dementia.

“There are pockets of good practice but there’s a need for greater support.”

The proportion of patients older than 85 is expected to more than double by 2030, he said. “That means more people with disabilities who require care”.

Andrew Chidgey, the director of external affairs at the Alzheimer’s Society, said: “One in three people over 65 will die with dementia.

“Yet we regularly hear about people not being treated with the dignity and respect they deserve at the end of their life. As the population ages it’s vital that care workers are equipped with the knowledge and the tools needed to provide the best quality palliative care. A key aspect of this is ensuring people are as free from pain and distress as possible.”

Tes Smith, social care programme manager at Macmillan Cancer Support, said it was “vital” for there to be a shift in the way end-of-life care was supported.

She said: “With the right support, 73 per cent of people with cancer would prefer to die at home. Currently only 27 per cent are able to do so.

“Community nursing for people in the last weeks and months of their lives would go a long way to making this choice a reality; freeing up desperately needed funds for the NHS and granting patients their dying wish.”

http://www.telegraph.co.uk/health/