End of Life Care: Gold Standards Framework (Heaven's door)

INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL

individual

PRIMARY CARE	ACUTE CARE
CARE HOMES	DEMENTIA (CARE)

group - population

Looking at a table 'GOLD STANDARDS SET BY BENCHMARK PROGRAMME' (p.23) in Prof. Thomas's HSJ article, I could see an instant fit between the four listed care contexts and the domains of Hodges' model.

There are also many overlaps and of course Hodges' model is an idealised resource. For example,  governance applies across all the above and in that way all can be placed in the POLITICAL domain.

Further points explaining the above includes:

• The GP and primary care seeing the person first not the diagnosis. Again in this sense - respect and dignity we can place all these care specialisms in the INTERPERSONAL. You would hope that primary care 'know' the patient as a person, an individual; or at least through recourse to the primary care record.
• If a care home 'works' it will be able to deliver care almost transparently, it is not a process but a social gathering. It is not the person's home (their home is not something to be forgotten, replaced like their past), but it seeks to emulate this as far as possible. Care is a routine that is also personalised and even at the end of life there is peace, calm and dignity.
• Dementia care is a political challenge, a priority and challenge across all the domains. As in the previous post - what training is provided to Health Care Assistants and other staff? How is the strategy for dementia progressing across all these care environments?

The National Gold Standards Framework Centre in End of Life Care

Thomas, K. (2014) 'End of life care is a litmus test for the whole of the NHS'.  HSJ, 31 January, 124, 6384, 21-23.