When Christina first came to Longview she brought a new lease of life to the service. Yet as time passed and her health failed, our staff team began their journey to support her last wishes.
Standing next to the grave, Christine and Brenda reflected on their journey over the past three years, and the life of Christina Baxter.
When she first came to Longview, our CQC care home on the outskirts of Liverpool, Christina discovered a new lease of life. Isolated in the community, Christina’s mental and physical health had declined to the point where she could no longer live independently.
“She was very outspoken, very set in her ways” Christine reflected. “She would cause murder with the other residents, but she was very well liked and she always had people’s backs when something was wrong.
“She’d be the first to speak with the team if something needed sorting to help the other residents; she was a very popular figure.”
Soon Christina was taking part in group activities at Longview, discovering new hobbies and having her say on the running of the service and co-production as service rep.
As her key worker, Christine began to build a rapport with Christina: “She took a while to settle in, but from the start she had warmed to me; I think it was because we were close in age and that reassured her, she was reluctant to engage with some of the younger key workers. She’d say ‘they’re just kids’.
However a year after she arrived, Christina was diagnoses with Chronic Obstructive Pulmonary disease (COP) a degenerating lung condition:
“Throughout her life Christina had had problems with addiction and had always been a heavy smoker. She’d led a very chaotic life, and quite a sad one.”
As her key worker, Christine worked closely with Christina as she came to terms with her condition: “She put on a brave face, but we knew she was scared; we all were. The doctor’s said that the condition could be controlled with a number of lifestyle changes, but Christina wouldn’t give up smoking, she’d had a lot of problems with addiction through her life.”
Over time her condition deteriorated and the team at Longview had a decision to make.
“We’d been working very closely with the local COPD team and the District Nurse. They’d told us that her condition was getting worse and that she’d need transferring to hospital to help with end of life care, but that wasn’t what Christina wanted.”
Christina’s family lived in Scotland and she had limited contact with one of her brother’s through Facebook. Her partner had died ten years previously and since moving in, Longview had become her home.
“We talked to her and she told us that she wanted to die here, in her home. We couldn’t let her die in hospital surrounded by strangers; we knew we had to do something.”
Over the coming weeks the team talked at length with their Locality Manager, the District Nurse and the COPD team to decide on what to do.
“It was a tough decision. On the one hand we had no experience of end of life care and the service would need a lot of adjustments to cope, but on the other hand we wanted to honour Christina’s wishes and support her to die in her home.”
In the end it was agreed that Longview would provide the end of life care for Christina: “It was a lot of learning as we went. First of all the hospital had to deliver an adjustable bed as well as the end of life medication.
“Throughout the whole transition I was amazed by the team around me. Everyone pulled together to swap shifts, volunteer their time and learn new things to make sure we were doing right by Christina. I had so much respect for everyone.”
As time went on Christina’s health deteriorated further: “She couldn’t get from one end of the corridor to the other, she found it very hard to breathe and had a very heavy cough. It was a distressing time for us all.
“After a while we had to talk to her about signing the do not resuscitate form. Until that point she was adamant she’d be ok, she was in denial about things.
“It was such a difficult conversation to have. The nurse sat down with her and explained how distressing resuscitation would be for her and for staff; the nurses knew that she wouldn’t survive such an experience, it was and emotional conversation to have.”
After some time Christina signed the DNR form. In the following weeks Christina’s health began to decline. She passed away on the 3rd of July 2015.
“It was very sad for us all. Christina had brought us all closer together, not only the staff at Longview, but our colleagues from the NHS and the COPD team.”
Christina’s impact was such that her funeral was attended by everyone who had cared for her toward the end of her life from both Longview and the NHS, as well as her family from Scotland.
Weeks later as Christine and Brenda scattered her ashes on the grave of her partner they reflected on the legacy Christina had left behind.
“The whole thing was a fantastic team effort. It was an honour for us to fulfil her wishes and to help her die at home where she’d found a level of comfort at the end of a chaotic life.”
“Our relationships with the local teams have remained strong and since then we’ve had a number of residents with physical health needs, we certainly feel more confident to provide support to them and are ready should another person require end of life care.”