Laura Green

Archaeology and modern reflections on death

Professionals working with patients at end of life need to feel comfortable and confident discussing death, dying and bereavement (DDB), however this is not always the case.1 2 The Continuing Bonds Project sought to explore the impact of archaeology on the confidence and comfort for health and social care professionals and students in talking about DDB.3 4 Case studies from the distant and recent past, across cultures and geographical space, were used in themed workshops facilitating participants to reflect on and discuss memorialisation, legacy, age and circumstance of death, images of the dead, ancestors, place, treatment of the dead and objects. The impact of the workshops has been evaluated using a number of methods including discussion with participants as to what they did as a consequence of attending a workshop. As an illustration of the impact that is emerging we share here one specific outcome: a poem that one participant wrote as a consequence of attending a workshop and the continued impact on …

P-117 “Breathe better”: exploring the potential impact of support groups for people with end-stage copd

Background The Breathe Better group (BBG) has been running from Marie Curie Hospice Bradford (MCHB) since 2008. It aims to reduce dyspnoea, improve quality of life and mastery of illness for patients with end stage COPD. It uses four methods: education, exercise, pharmacological management and individual consultations. We aimed to ascertain the impact of the BBG. Method A retrospective longitudinal study was performed on patients referred between August 2010 and June 2013. Data were collected on shuttle walk distance, mastery, Hospital Anxiety and Depression Scores (HADS), advance care planning (ACP), and mortality. Outcomes were analysed using a paired t-test. Results Data from 56 patients was analysed. Mean shuttle walk distance increased by an average of 10.8m which was statistically significant (p = 0.05). Total HADS score improved by 2 points. 65% of patients had an ACP after the group, compared with 24% prior to commencement. 76% patients died with two years of the group. Place of death (below) demonstrates an increase in rates of hospice death when compared with regional and national COPD data. Place of Death (n = 45) Care home 11% Home 7% Hospital 38% Hospice 31% Not recorded 13% Discussion Results suggest that BBG improves shuttle walk distance and recording of ACP which appears to influence place of death. Missing data means conclusions are based on a small sample size. Improved data recording is a local priority in order to render future evaluations more meaningful. Implications Other hospices may wish to consider pilot schemes especially as often this patient group are unable to access current NHS schemes such as Pulmonary Rehabilitation due to their poor health. A larger study with a control group of patients who did not attend will allow more accurate evaluation.

O-11 My life: reporting on a novel use of digital legacy software in hospice day therapy

Background Starting conversations about the end-of-life is known to be challenging for patients, families and professionals. The MyLife software contains a range of interactive therapeutic tools, including reminiscence abilities, social inclusion activities, and person centred, individualised “All About Me” passports. In addition, we are using the software to develop electronic life story memory books, that can be left as a legacy to loved ones. We are working with My Dementia Improvement Network to develop cloud-based storage to enable people’s families from around the world to be able to contribute to the memory book. We are linking in with the local hospital dementia lead nurse to use the cloud to enable patients to continue to develop their books whilst in the hospice, hospital or at home. Aim We saw an opportunity for this software to be useful in facilitating preparation for the end-of-life for patients and families using our hospice services. Method Equipment was funded using a Yorkshire Young Achievers bid in 2014. We have trained four staff members as “super-users”, by getting them to complete their own Life Story books. Findings We have used the software with nine patients including a young man with Motor Neurone Disease who has two young children and a number of family members living abroad. Initial evaluation with staff, patients and families suggests that it provides an opportunity for conversations about memories, wishes, hopes and fears. We believe the intervention enables rapport to be built and has been reported as being therapeutic in its own right. Implications We are working with the software designers to develop additional language capabilities to enable it to be used with different cultural identities. We intend to develop robust evaluation measures, such as patient perceptions, the impact of the MyLife content on bereaved family members, and enhancing staff understanding of existing networks.