Stand by me. 1

Joan Bakewell explores end of life experiences; not everyone is old or elderly. Many people talk about the difficulty of discussing death. Julian Able is chair of Public Health Palliative Care UK and a retired oncologist, Alan Axford talk about the cuts in health services which has led to the loss of many beds where people could die quietly in wards. Able remarks that although the quality of medical care is better, death in hospitals has become institutionalised. At home, care packages can be available but they involve many people. In hospitals, non-cancer patients can continually yo-yo back and forth to hospital without discussions about end of life choices. St Joseph's Hospice in Hackney works with the local community addressing quality of life. 'Compassionate Neighbours' is a name of the befriending service. Services are now being targeted at the non-white communities in London. Some of the participants testify to the mutual benefits of the scheme. A similar scheme in Wales, Hospice at Home, has been established in Aberystwyth. The befrienders get some training, although the care is provided by the community nurses. Loneliness and isolation are typical problems and dying can take a very long time. Various people's experiences of end of life are described. Hospitals have the means via their IT systems to flag when certain combinations of drugs are prescribed; this is when specialist palliative care nurses can be deployed and an end of life conversation can take place. Often transport can be the issue which prevents people returning home.