Mrs Down was an elderly lady diagnosed with a cancer of the lung. She had received two or three courses of radiotherapy treatment from the oncology team – this had extended both the length and quality of her life for several months.  She was supported at home by her GP, District nurse and St Lukes’ Hospice community nurse.

She was admitted to hospital via her GP and was brought direct to the Medical Assessment unit.  She was short of breath, with a build-up of fluid in her lungs and a general deterioration of her health.  The Respiratory Consultant worked with the Clinical Nurse Specialist for Older People, the Specialist Palliative Care team and the nursing and medical team on the Medical Assessment Unit.  Mrs Down's breathlessness, fluid build-up and pain were treated.  There was no further option for radiotherapy and it was clear to the team that the treatment options were of a palliative nature.  The Specialist Palliative Care team and Clinical Nurse Specialist for Older People discussed this with Mrs Down and her family.

Mrs Down and her family expressed the wish for her to be discharged home, to be nursed there until she passed away.  It was clear to the clinical teams that this would only be for a matter of days.  The Liverpool Care Pathway was instigated – which provides a holistic approach to patient care, ensuring good communication between professionals and agencies.  Mrs Down's continuing health needs were assessed on the Medical Assessment Unit by the Specialist Palliative Care team who then 'fast tracked' the arrangements for discharge.  Communication with the GP and District nursing team enabled the appropriate community equipment to be put in place for discharge.

Mrs Down was discharged the day after her acute admission to hospital, on the Liverpool Care Pathway, with the support of District nurses and the St Lukes Hospice community team.  She was at home for twelve hours, with her family, before peacefully passing away.

Her daughter took the time to ring the Medical Assessment Unit to thank the whole team for going to so much effort and working so promptly to ensure that her mum could be discharged home.  Mrs Down had passed away peacefully with all her family present, in the family home in which she had been born.