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Is the Liverpool Plan just another name for euthanasia

(58 Posts)
etheltbags1 Sat 14-Mar-15 09:26:31

My friend called the other day full of tears, her aunt aged 86 is in a care home with days to live. She has been discharged from hospital and back in her old room where she was happy and can see her old friends.
They have put her on the Liverpool plan which means they are removing her medication apart from painkillers, removing nourishment (her condition means she cant swallow solids) and are literally starving her to death albeit in a nice way. I understood that this plan was now banned and was originally for people who are beyond understanding, ie in a coma that they are not likely to recover from.
This lady is awake and chatting to my friend who is her next of kin and has not given permission for the Liverpool plan to be put in place.
It seems to me that its a form of euthanasia.
I would have thought that if the lady is dying but awake would it not be better to feed her liquids and drinks, perhaps cups of tea etc until nature takes its course. I don't have a lot of medical understanding about this but would welcome comments.

FlicketyB Sun 22-Mar-15 17:32:03

etheltbags I am in absolute agreement with you.

rosequartz Wed 18-Mar-15 19:32:04

I agree too, etheltbags as unfortunately the LCP is not always implemented to the letter or with compassion, and quite honestly no-one has the right to withdraw the basics of life from another human being. No-one can know how that sick person feels.
Protocols may be set up but are not always followed by all staff. Our family has had horrific experience of this.

It is euthanisia in all but name.

One day in the future people will in all probability look back on it with horror.

harrigran Wed 18-Mar-15 19:10:45

There was a case in a newspaper yesterday, a man was asked to give permission to turn off his wife's life support because she would not recover. The lady did recover and is enjoying her life. I think the bottom line is nobody really knows so yes I agree *etheltbags.

etheltbags1 Wed 18-Mar-15 18:59:04

iam64, I have not been online for a couple of days so have just read your post regarding my supposed 'winding up' of readers of this subject.
NO, I am not winding anyone up, I find your remarks offensive and away from the subject. I stand by my original posts on this subject and I cannot see why anyone need be on any 'plan'. Many older people have really serious illnesses and recover completely. How can any medical staff know how long anyone has to live. My relative was given 1 month with his cancer, he lived for another 32 years.
Why cant sick and/or elderly just be looked after with care and compassion like anyone else. Why should they be different, a cup of tea and a biscuit is no different given to a dying person than to another who is seriously ill. Also someone who is ill and not expected to die could die from an unexpected cause such as a heart attack.
I really don't understand all the fuss. My friend had just e mailed me to say her aunt died yesterday btw.

rosequartz Tue 17-Mar-15 10:53:01

Thank goodness - something needed to change in that hospital.

End of life care there = neglect and cruelty under the last government.

durhamjen Mon 16-Mar-15 20:34:46

This is today's news. Cancer and end-of-life care in Stafford being privatised.

https://opendemocracy.net/ournhs/caroline-molloy/leak-reveals-worrying-truth-behind-biggest-nhs-privatisation-yet

Ana Mon 16-Mar-15 20:27:04

Is this newspaper report acceptable, Jane10? It's nearly a year old, but many of the points it addresses still apply.

www.theguardian.com/society/2014/may/15/end-of-life-care-uk-improvements-nhs-patients

Jane10 Mon 16-Mar-15 20:16:06

I would worry about the 'data' available in certain newspapers!

FlicketyB Mon 16-Mar-15 19:42:16

Well, you wouldn't, they are usually elderly, have dementia and other medical problems, or sedated. The papers almost daily have stories from families about elderly relations who went into hospital ill but functioning and are reduced to a confused non-functioning state and then given up on and sedated and put on a nil by mouth regime as death is imminent.

I think people are very negative about their deaths, always assuming it is going to be nasty, miserable and painful. Yes, for some it is like that but more and more are living to extreme old age, healthy, well and functioning and then dying in their sleep or after a short illness without much suffering.

I have decided quite consciously to make no decisions about how I am to be treated as I near death as I do not yet know when it will be, how old I will be, what health problems I will have, whether I will be in pain, what my mental condition will be, nor how I will feel about it at the time.

I do not like making decisions when the data needed to inform the decision is grossly inadequate. And when the decision is quite literally a matter of life and death, then I want to be sure that I have as much data as possible before I reach any decision.

loopylou Mon 16-Mar-15 17:55:35

Definitely not alone Granjura
End of Life Care Pathways are used to inform and direct the patient's wishes and where necessary, those of the relatives, on the Older People's unit where I'm currently working.
Resuscitation status is also discussed with the patient and relatives, by the Consultant and documented.
These wishes are followed closely - and if necessarily changed as the patient wishes. They include what level of resuscitation, it is agreed and reviewed regularly.

granjura Mon 16-Mar-15 17:38:52

Indeed Jane10- and recently highlighted again because of the demise (of natural causes) of one of its great supporter, Terry Pratchett.

I feel truly privileged that I live in a country where, if ever I was in a final, painful and undignified end of life situation, or suffering in final stages of a terrible disease like Motor-neurone disease- I would be able to make the choice to die at home, in my own bed or favourite armchair, with or without family and friends, at a time entirely of my own choosing, and professional help. For me, the fear of living too long in terrible conditions is far far greater- and I am NOT alone.

harrigran Mon 16-Mar-15 17:35:21

I understood that LCP had been stopped by NHS last year and should not be implemented.

Jane10 Mon 16-Mar-15 17:32:39

What about all the 'right to die' lobby? The assisted suicide bill proposal seems to have a lot of support flickety. Can't say I've heard much from people afraid of being despatched against their will.

petallus Mon 16-Mar-15 17:16:58

If I'm out of date on that one I'm pleased.

I'm not worried about being despatched too soon though.

FlicketyB Mon 16-Mar-15 16:40:31

Do they? I thought all that went out of the window years ago. The only comments I have seen in recent years is from people who fear being dispatched to soon as the result of poor and inadequate care.

petallus Mon 16-Mar-15 13:02:47

Many people worry about being kept alive with aggressive interventions by well meaning medical staff when they are terminally ill, in pain and with no quality of life.

I like the sound of the LCP.

Jane10 Mon 16-Mar-15 10:18:54

I think the really tricky problem is probably in assessing whether or not a person just wants to be let go. My Dad was furious at being resuscitated: he had clearly stated a DNR. As a doctor who worked in end of life care, he knew exactly what he didn't want, nevertheless a young SHO resuscitated him in the middle of the night. He died the next day after demanding champagne and insisting on drinking it despite being fully aware that his swallow reflex had gone. He said goodbye to us and said that he was going to sleep. And he did, forever. A way to go that the LCP hadn't considered!
My mother and MIL just stopped eating and drinking and drifted away. Assessing capacity and clarifying these difficult, vital, potentially final wishes is very difficult . It takes real experience to assess this accurately. I suppose the LCP was a way of trying to standardise this and highlight the key steps needing to be followed but allowing for individual variation.
Staff also would benefit from training in managing bereaved families after the event. We were very lucky to be treated with great kindness and consideration after mother and MIL's demises. Much appreciated. As ever its the little things............

Anya Mon 16-Mar-15 08:02:09

Yes, indeed Jane and I agree.

BUT, how well trained does a person need to be to realise that patients, particularly the elderly, need to eat and drink to stay alive?

And if some staff CBA to help them do this, then all the training in the world won't change this attitude.

Jane10 Mon 16-Mar-15 07:43:47

My suggestion re a "One born" type of programme was to bring this time of life and the very different and difficult care needs to public attention. Currently I think there is massive unawareness of this time of life. Only people directly involved know what's going on or not. A programme hopefully highlighting the dilemmas and hopefully good professional practice could open up this area and potentially lead to an understanding of the need for increased funding and better staffing levels and training leading to more universal higher standards.

Anya Mon 16-Mar-15 07:01:49

Your post sums it up well Faye. Also the failure to ensure basic nursing care, such as ensuring patients are kept hydrated and nourished is not limited to end of life care. Too many elderly patients admitted to our hospitals for minor operations or conditions are left to feed themselves. I have witnessed food and drinks being removed, undrunk and uneaten, despite protests from the patient that they are hungry and thirsty and need help.

Purpledaffodil Mon 16-Mar-15 04:14:46

My understanding is that LCP as used by the hospice movement involved keeping the patient comfortable, but not giving painful procedures or aggressive resuscitation. I agree with Faye that it was in danger of being used to stop bed blocking in the NHS.
On the other hand, I have known several cases of very old and sick people who were aggressively resuscitated to live in pain with broken ribs for a few more weeks. My own DF died aged 92 in a hospice on LCP three years ago. He was never denied anything, but slipped away while he was being washed and made comfortable.He had turned down the offer of surgery for his cancer, saying "I've had a good innings". He'd made his own decisions and LCP supported him in this.

Faye Mon 16-Mar-15 03:38:03

By the stories on here it has worked for some people but not for others. If people have died when it was not their time because they were refused food and liquids then the LCP has not worked as it was meant to and people have been killed.

Amarmai, this article in the Guardian is possibly a reason: "There must be no incentive payments to hospitals to put people on end of life care as occurred with the pathway. This was intended to adopt best practice but has been interpreted as payments to speed up patient's demise."

I share your horror ethel, of people being refused food and liquids when they want them. My mother who died at home refused food and drinks. She slept most of the day, the next morning she woke up and said she would have her cup of tea now. She died peacefully late that night.

There is also the other extreme which is worrying and happens far too often is when people who are dying are revived.

amarmai Mon 16-Mar-15 00:34:10

Why is ethel being silenced? Decades ago I received a letter by regular mail sent by my sister from England to Canada. She told me that by the time i received it our mother would have died in a hospital in England. My sister had been given poa for health decisions and my brother for financial decisions. I left immediately and for a week spent most of each day by my mother's side. I was there am and pm and discovered that food and water was left on her bedside table but none of it was brought to her mouth. She told me to get her bananas and yoghurt which i helped her to eat until she was able to do so herself. She was being allowed to starve to death with my brother and sister's permission. Had i not reached her as quickly as possible she would not have lived for another 10 years. This still seems to me to be barbaric , yet over the years of telling others this story i have heard many similar here in Canada and elsewhere. The question is why?

FlicketyB Sun 15-Mar-15 17:39:46

I think the problem is that; yes, there is very good care in the NHS but as Stafford, Morecambe, Colchester and some of the Kent hospitals have shown there is also some systematic and systemic poor care and those most likely to receive the poor care are the vulnerable elderly.

Over the last 15 years I have had responsibility for the care of four different elderly relatives in hospitals 150 miles apart and in all but one case the hospital care they have received has been anything from poor to appalling.

I do not think TV programmes help. What relevance has 'One born every minute' to the appalling care and problems in the maternity unit at Morecambe?

Jane10 Sun 15-Mar-15 16:32:13

Only the bad news about the poor old NHS ever makes it to the public. No one is interested in all the excellent care that the majority of people actually receive. Of course bad care should be identified and rectified but a tiny minority of people are responsible for it. Others are just doing the best they can under sometimes difficult circumstances. We should have a TV programme like 'One born every minute ' based in a care of the elderly unit!