It has recently been reported that the family of Brenda Grant received compensation from the NHS in respect of the way in which Brenda had been treated prior to her death.Brenda had made an advanced directive (sometimes referred to as a living will) in which she was clear that she would not want to be artificially fed under certain circumstances. Brenda took the step of preparing this document having watched her own mother suffer as a result of dementia.
The hospital had not discovered the document in a thick bundle of medical documents and none of the family knew about it. The intervention of the GP who did know of its existence at a late stage meant that her wishes were honoured.
This highlights a number of issues regarding communication. Brenda should have made her family or a family member aware of her wishes. They would have been able to press the hospital earlier on.
The hospital should have highlighted the existence of the advanced directive within her medical notes (having agreed to do so on the front cover going forwards).
Brenda could also have prepared a Power of Attorney. Originally only an Enduring Power of Attorney was available. This was limited to property and financial affairs only. Therefore an advance directive would be used in support in relation to issues regarding health and welfare. The newer Lasting Powers of Attorney cover both property and finance and also health and welfare. Judicious use of the health and welfare power of attorney can address issues such as the removal of life-sustaining treatment. The major benefit being that those appointed have to sign the form to say that they will accept responsibility if required. Therefore someone knows that there are recorded wishes and they are able to speak up.
The press release states that the GP had to assist the family in arguing with the hospital to persuade them to follow the wishes once the document was found in the medical notes. It is probable that the hospital may take more notice of a document (the lasting power of attorney for health and welfare) that is registered with the court than a document that is not (the advance directive).