Closing the Care Loop
At Larwood and Bawtry Community Nursing Team they identified that they would like to be able to close the loop of care when one of their patients dies. In view of this the team have been working hard to gain Verification of Death competencies. The importance of this last moment of care was shown recently when our district nurses Angela Bell and Kay Stocks where called to a patient home to carry out last offices and verification of death.
The patient had been on the Larwood and Bawtry Community Team caseload for around 3 months, during which time Angela Bell had developed a trusting, honest and caring relationship with both the patient and his wife. Often having to hold difficult conversations regarding deterioration of condition and preparing family for End of Life eventuality, the community nursing team visited regularly for pressure care and general support with Angela Bell, District Nurse, visiting weekly for complex palliative support.
During the conversations the patient family requested if possible that the community nursing team be the healthcare professionals to close the loop of care when the patient died. Thankfully the team were able to meet this request, the patient’s wife contacted the service and they were able to send our nurses who arrived at their home within 20 minutes.
On arrival Angela and Kay gave emotional support to the patient wife while discussing the next steps of the process, always keeping her informed but being mindful of the situation. Angela supported the wife by contacting the chosen Funeral Directors. Following the verification of death process, which Angela was training Kay to complete during the visit, the wife selected clothing for the patient to wear on his final journey from the home. Angela and Kay prepared the patient with dignity and respect while awaiting the arrival of the Funeral Directors which was longer than expected due to the Pandemic complexities. Angela and Kay sat with the patient wife while she contacted other family members and remained with her as she expressed that she did not want to be alone when the patient left their home as she felt this was going to be the hardest part of his final journey.
Kay and Angela remained at the property and gave all the information to the Funeral Directors, closing the blinds and asking the patients wife to show them cards that had been sent while the patient was taken from the home for the final time.
Closing the loop is about being able to offer dignity and respect to the patient while supporting the needs of the grieving family and friends, the team feel this identifies how important being able to support the family even in these difficult circumstances with Covid-19, is so very important and something that the family will remember for years to come. A nurse is not always just a person they are a comfort that is irreplaceable.
