Planning for a crisis and end of life care

Carers often tell us that they are worried about what will happen to the person they care for in an emergency situation or if they need to plan for end of life care.

How your local authority can help with planning your care

The Care Act 2014 makes clear that local authorities must provide or arrange services that help to prevent people developing care and support needs, or delay people deteriorating to the point where they would need ongoing care and support.

Even if you don’t want or need financial assistance with your care, your local authority can still help you plan your care, so it is worth contacting the adult social services to find out the options available to you and your family.

Local authorities must work with people in their areas to provide or arrange services that help to keep people well and independent. This should include identifying the local support and resources already available, and helping people to access them.

End of life care

We provide services to ensure that you can receive the best possible care, and treatment that respects your wishes at the end of life. As far as possible we want to make sure you can be supported in the place you have chosen, whether this is at home, in a care home, or in a hospice.

End of life care is for everyone who is coming to the end of life, including people who have an advanced, untreatable or life-threatening illness.

This care involves managing pain and symptoms to make sure the last stages of a person's life are as comfortable as possible. It is sometimes called "palliative care".  This means trying to reduce pain and discomfort rather than curing or slowing down the illness.

End of life care is for people who can't get better, to make them feel more comfortable. The services provided also support their family, who are concerned about their relative's wellbeing at this difficult time.

End of life care can also include psychological, social and spiritual support to help both the patients and their families to adjust and cope.

Who provides it

There are many different people who could be involved in end of life care, depending on a person's health and social care needs. They could include:

  • hospital doctors and nurses
  • your doctor
  • counsellors
  • social workers
  • religious ministers
  • physiotherapists

Most hospitals have special palliative care teams. They work with other staff to deliver end of life care to patients in hospital, in care homes, in hospices and at home.

The first person you speak to should be your doctor. They will be able to tell about all the services that are available and give you advice.

Coping with bereavement

The death of a loved one can be devastating. Bereavement counsellor Sarah Smith, who works at Trinity Hospice in London, describes some of the feelings that can arise from losing someone, and where you can go for help and support.

She says: "You might feel a lot of emotions at once, or feel you're having a good day, then you wake up and feel worse again."

She adds: "It's like waves on a beach. You can be standing in water up to your knees and feel you can cope, then suddenly a big wave comes and knocks you off your feet."

Stages of bereavement or grief

Experts generally accept there are four stages of bereavement:

  • accepting that your loss is real
  • experiencing the pain of grief
  • adjusting to life without the person who has died 
  • putting less emotional energy into grieving and putting it into something new - in other words, moving on

You'll probably go through all these stages, but you won't necessarily move smoothly from one to the next. Your grief might feel chaotic and out of control, but these feelings will eventually become less intense.

Feelings of grief

Give yourself time - these feelings will pass. You might feel:

  • shock and numbness - this is usually the first reaction to the death, and people often speak of being in a daze
  • overwhelming sadness, with lots of crying
  • tiredness or exhaustion
  • anger - for example, towards the person who died, their illness, or God
  • guilt - for example, guilt about feeling angry, about something you said or didn't say, or about not being able to stop your loved one dying

"These feelings are all perfectly normal," says Sarah. "The negative feelings don't make you a bad person. Lots of people feel guilty about their anger, but it's OK to be angry and to question why."

She adds some people become forgetful and less able to concentrate. You might lose things, such as your keys. This is because your mind is distracted by bereavement and grief, says Sarah. You're not losing your sanity.

More information regarding what to do after someone dies, such as registering the death and planning a funeral are also available.

Coping with grief

Talking and sharing your feelings with someone can help. Don't go through this alone. For some people, relying on family and friends is the best way to cope. 

Help is also available through local bereavement services such as:

  • your local hospice
  • the national Cruse helpline on 0808 808 1677
  • your GP 

A bereavement counsellor can give you time and space to talk about your feelings, including the person who has died, your relationship, family, work, fears and the future.

You can have access to a bereavement counsellor at any time, even if the person you lost died a long time ago.

A few useful links:

Adult Intake and Access Team

020 8227 2915