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Last Updated: Tuesday, 26 February 2008, 00:05 GMT
Dying at home scheme's cash plea
By Adam Brimelow
Health correspondent, BBC News

Marie Curie Cancer nurse
The majority of people say they would like to die at home
A leading charity says plans to help more terminally ill people die at home under a pioneering nursing scheme are at risk due to a lack of funding.

Marie Curie Cancer Care says 2m more a year would allow it to extend a scheme which has more than doubled the number spending their last days at home.

The warning comes as a YouGov survey suggests more than 70% of people would feel happiest dying at home.

But fewer than one in seven think they would get the care they need.

Marie Curie nurses work across the UK looking after people who want to die at home.

The charity is worried that many people who would like to spend their last days in their own familiar surroundings end up dying in hospital.

'A privilege'

Gwen Eldred is part of Marie Curie's Rapid Response team of nurses and healthcare assistants in Boston, Lincolnshire, which has contributed to a dramatic increase in the numbers able to die at home.

You know that you are giving them the choice that - without our service - I don't think would be there
Gwen Eldred
Rapid Response team

She is on a routine visit to 77-year-old Bob Standwell, a patient with pulmonary fibrosis, who is struggling to get air into his lungs.

"Nine times out of ten with him it tends to be an unplanned visit, usually caused by a panic attack," says Gwen.

"He can't get his breath, and his wife tends to ring us up and says 'can you come and give Bob a hand. He's just having a bit of difficulty breathing at the minute' and we'll just go and help him."

The rapid response team have the expertise to support patients and their carers through crises, so they do not have to dial 999 and be hauled off to A and E.

The scheme also provides discharge nurses who help terminally ill patients who want to leave hospital to go back to their homes.

Gwen Eldred says it is a privilege to help people at such an important time.

"You've been invited into someone's home at a very delicate time in someone's life, and you're welcomed into that family.

"You're made to feel part of them, and you really are making a difference, you know that you are giving them the choice that - without our service - I don't think would be there."

All parts of the health system need to act, listen and give us a chance to work with them
Thomas Hughes-Hallett
Marie Curie Cancer Care

Marie Curie has been talking to the government about extending the scheme across England.

The charity's chief executive, Thomas Hughes-Hallett, says ministers are supportive, but have not come up with the money that is needed - 2m extra each year for the next three years.

"My main worry is that without the funding it won't happen. And this is the moment that it must happen," he says.

"We want people to die at home, people want to die at home, and we must ensure that the government is listening.

"All parts of the health system need to act, listen and give us a chance to work with them, to deliver the results of this extraordinary programme."

The charity has also released the findings of a UK-wide YouGov survey which suggests that more than 70% of people would feel happiest dying at home.

In practice three times more people end their lives in hospital than at home.

Top priority

Only about one in seven of those surveyed thought they would get the care they would need at home.

Many were concerned about pain, yet Marie Curie says for 80% of cancer patients, pain can be managed easily at home, and that a further 10% can remain home with the right kind of care.

Ministers say this issue is a top priority.

The government has written to health authorities encouraging them to back the programme - but it says ultimately these decisions must be taken locally.

Bob Standwell's wife of 55 years, Nan, could not speak too highly of the support she received.

"He said I don't want to go back in hospital. I like being at home. I promised that he wouldn't go back in hospital if I could possibly avoid it. I can't think of anything at all which is as helpful to people in our situation as the response team."

Bob was too poorly to speak the day I came. The following day he died, at home.

A palliative care nurse on her work


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