Death itself. 3

Joan Bakewell explores end of life experiences and what choices are available at the end of life. Some experiences both positive and negative are recounted. The panel who discuss these issues on this programme are Maggie Bissett, Palliative Care Nurse Consultant at Central and North West London NHS Foundation Trust, Louise Anderson, recently bereaved and Cara Mair, a funeral director. The actual point of death can be hard to be predict and Maggie Bissett lists some of the indicators. Louise's husband was diagnosed with terminal pancreatic cancer and wanted to die at home; the whole extended family became involved. The Liverpool Care Pathway was a plan for people at the end of life designed for junior clinicians. Unfortunately, it was designed to be a prompt not a template for end of life care. A play, 'Homeward Bound' has been written for medical professionals about the way in which end of life care has been medicalised and overwhelms the patient and family with process and procedure. The play was staged at a medical conference and medical professionals corroborate that the NHS is not able to offer personalised end-of-life care. Maggie Bissett talks about examples of how people have created an advance decision document which can cover many scenarios. A new bread of doulas are involved in nursing the dying; Hermione Elliott has set up a charity 'LIving Well, Dying Well' based in her personal experience of her parents dying in order to support and empower families. Cara Mair talks about how people do not need to immediately call a funeral director. She talks about the physiological processes a body experiences at death. Slowing the decomposition process is described.