There are no dress rehearsals when it comes to where we are and who we are with when we die – so it’s crucial that people have as much choice and control over the situation as possible. This is important not only to the person who is at the end of their life, but also those close to them. A person’s last days will stay with family and friends forever, so it is important that they should be left with a lasting, positive memory of their loved one receiving good quality care in a place of their choice.
What is not acceptable is for someone to end their days against their wishes in an expensive hospital bed, purely because they did not have the right support to die at home. Sadly, we know far too many people currently do not die in a place of their choosing. Macmillan Cancer Support found that 36,000 people with cancer who wanted to die at home died in hospital in England in 2012. In fact, 73 per cent of people living with cancer would prefer to die at home, but figures show only 30 per cent are currently able to do so. We cannot continue to have final experiences and enduring memories shaped by the absence of choice for people at the end of life.
Unnecessary hospital admissions can occur because people who are caring for someone who is dying at home reach a breaking point or they feel unable to give their loved one what they need in terms of practical support. Families and friends of those at the end of life can often only do so much at such an emotional time. Having help with basic practical tasks such as cooking, washing dressing would enable them to experience a high quality of care, and ultimately support them to stay at home. Yet the current means-tested threshold for free social care of £23,250 in assets excludes many people and presents terrible financial dilemmas to families at a time of distress.
If people at the end of life had access to free social care as part of a package of support at the end of life, then that would give choice where it is so often currently absent, and prevent friends and family from feeling overwhelmed by the practical aspects of looking after someone at the end of life.
There is broad acknowledgement that change is needed, with the Government already saying it sees ‘much merit’ in the principle of free social care for all at the end of life. The government’s review into choice at the end of life will be published in February, and I hope that free social care for people at the end of life is included in its recommendations. I was proud the Liberal Democrats voted in favour of the introduction of free social care at our party conference in the autumn. What is now needed is for this political will to be converted into action. It falls on the next government to make this simple and moral measure a reality.
* Annette Brook is the Liberal Democrat MP for Dorset and North Poole.