Life before death – improving and discussing end of life care

Dr Katherine Sleeman is an Academy grant awardee and a NIHR Clinician Scientist at King’s College London who studies how we care for people who are approaching the end of their lives.

My team recently made a very surprising finding: that elderly people suffering with dementia are attending emergency departments in the final months of their lives more than ever before.

In South-East London, where my research is focused, the figures have almost doubled over the last five years. 

Our research shows that half of all people with dementia will attend an emergency department in their last month of life. And yet we know that hospitalisation of people with dementia can lead to physical and cognitive decline. So, how can we prevent some of these avoidable hospital attendances?

I’m investigating the services and care provision that enable people to be looked after without resorting to hospital admission. For example, one interesting finding is that those in care homes are less likely to attend emergency departments.

Understanding why and how frequently people dying with dementia are being admitted to hospital is essential, not only to an overstretched health service but most importantly to improve the quality of care for these vulnerable patients and their families.

I have been involved with the Academy of Medical Sciences since I became an NIHR Clinical Lecturer in 2010, attending meetings to discuss my work and receiving a Starter Grant to develop my research. I’ve also benefited from the Academy’s mentoring scheme, and from their award winning media training .

As a clinician, I am motivated by improving the quality of life for people who have life-limiting illnesses. Some of these people have many months – or even years – to live, others will die within hours or days. Exploring people's symptoms and their fears around dying, and then helping to alleviate these, is hugely rewarding.

As an academic, my motivation is to try to ensure my research has impact on patients, carers and society. Public engagement is a key part of this and I have been working with the Academy as they plan a major public engagement project to explore people’s views about death and dying.

It’s frequently said that talking about death is a taboo. However, in my experience, people are often keen to share their experiences of end of life care and fascinated by research in this area.

Informing patients, the public and policy makers about research in palliative and end of life care is necessary to guide decisions for individuals, families and societies. Death will affect everyone but enriching the public discourse around palliative care will help people achieve their wishes and preferences at the end of life.

Dr Katherine Sleeman is a NIHR Clinician Scientist at King’s College London, Academy grant awardee and Academy mentor. She is currently working with the Academy to develop a project to engage people on the topic of death and dying. For more information visit this page. 

Find out more about the Academy's public engagement work on death and dying.

To find out more about supporting the work of the Academy, please see our dedicated support us webpage . 

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