Terminal Care in Shetland

Abstract

This paper describes provision for dying patients in the Shetland Isles, both in the author's practice – which serves 2,750 people, living in a 15-mile radius of Scalloway – and also the area as a whole, with about 23,000 people living on the 17 inhabited islands of the Shetland group. The possibilities for improving care are considered and existing models for hospice-type services are examined – and found to have little relevance to an area which is remote and has a small population. The importance of good symptom control and good nursing care is noted, and ways to improve these are put forward. The family doctor, who has adequate training and expertise in terminal care, is seen to have a unique opportunity for looking after both the dying patient and his family. This is particularly relevant in an area far from specialist services, because such patients are rarely more than 30 minutes by car from their family doctor's surgery.