I write in regard to The Liverpool Care Pathway ("'Misused' care pathway for dying patients to be abolished", The Herald, July 16).
That I have been teaching nurses for almost three decades and was a nurse beforehand underpins my understanding of the situation.
The end of life is a very important time for patients, their family and friends. Individualised and supportive care should be available to all at this time. We know there is excellent care provided in some situations but following Staffordshire and other situations reported in the media it is evident there is poor and unacceptable practice in this essential care.
Dr Bill Noble of Marie Curie Cancer Care has said the Liverpool Care Pathway works well in the environment it was designed and intended for, palliative care, which I believe to be true. Not everyone who dies does so in a specialist palliative care environment or with specialist palliative care support. Most people want to and would choose to die in their own home and in an ideal world appropriate care would be available for everyone.
Registered nurses are educated and prepared to care for people at the end of life and have the required skills. Environments focused on diagnosis and stabilising acutely ill people or in providing ongoing and curative care are often not the best places for the provision of end-of-life care. People have reported and others are aware of situations which have left families devastated not only with normal grief but the lack of care their relatives have received.
In the past many elderly people were cared for at the end of life in their own homes by their families with support from local doctors and nurses.
In our modern, complicated, busy secular lives people are often not confident to do this, believe they lack the skills or equipment, that local support will not be available or will be inadequate.
There is no excuse for poor end-of-life care, there is no need for a strict prescription or protocol such as the Liverpool Care Pathway at this time either but it is time the NHS ensured the provision of resources and put a process in place where people can be confident they will be cared for and supported at this time.
People should not be afraid of the end of life because they fear care will be lacking. It is just not acceptable.
People need to have confidence in the care system and should not be afraid to express their opinions for fear of care being withdrawn or not being optimal.
It is time for discussion about and development of care for end of life. This is something that everyone will need at the appropriate time.
Dr Morag Campbell,
18 Hillside Terrace,
Milton of Campsie.
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