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End of Life Care - can it really be everyone's business ?

I have always felt that the providing care and compassion at the end of someone's life is one of the absolute pillars of nursing and celebrated the mantra that end of life care is of course everyone's business. However a conversation I overheard at my local supermarket has sowed a seed of questioning on my part. Two elderly ladies were speaking about a local social housing tower block and complaining about the rubbish left within the reception area and the frequent destruction of the adjoining children's playground. One of the ladies had moved into the towers as a young newly wed expecting her first child, the tower had looked lovely, bright and palatial in comparison to the overcrowded east end tenement building she was moving from, but over the decades the palatial image had faded. "When we moved in" she said " we were told that caring for the communal areas were everyone's business, but in reality that meant that it was no one business, no one held responsibility, no one is held to account". The architects of these buildings had a vision of shared responsibility of a community that came together to look after their shared environment but this wasn't always how it worked out.

For many years now, at least since the publishing of the End of Life Care strategy (DH 2008) those of us with a desire to make a difference in end of life care have been focusing on ways to support the concept of care of the dying as everyone's business. Supporting various different workforces across a diverse and complex health and social care economy. Implementing different models and media of learning, supporting, caring, all with the vision of creating a compassionate workforce who acknowledge and accept that end of life care is indeed their business and getting it right is their responsibility. The concept of "everyone's business" is challenging my thinking

If indeed I woke up tomorrow and there was a movement within healthcare to make the same proclamation at the other end of the life's journey, at the start, at birth , a movement to make birth everyone's business, Would I be as enthusiastic? I think not and if truth be told Id probably be the first one out of here.

Maybe we need to consider if making end of life care everyone's business is a realistic aim, would we be right to change our focus to ensuring kindness and compassion is everyone's business and acknowledge that caring for people at different junctions in their life journey will be suited to people that are happy and passionate about that element of the life cycle. I am not saying we should stop striving towards creating a system wide approach where everyone can support those people approaching the final days and months of their life, just that the reality could be that end of life care just might not be everyone's business, but compassion and kindness could and should be.

Compassion and Kindness is everyone's Business

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That concept of everyones business is simple and logical, but as its clearly indicated by the overhead conversation no one takes resposibility. The project and reality is how as experts in caring for patients who are dying do we empower everyone to make it everyone's business. How can we make this possible?

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