Why hospice care must never be taken for granted
PUBLISHED: 07:00 05 October 2020
This is What it Takes is the theme of this year’s Hospice Care Week (October 5-11.) Medical director Dr Corinna Midgley and palliative care consultant Dr Pia Amsler from Saint Francis Hospice – which cares for people from Havering, Barking and Dagenham and Redbridge – share their thoughts on what makes the charity such an integral part of the community and one we must never take for granted.
Everyone’s life matters and hospice care is about helping people to live as well as they can and when the time comes, to help people to die as well as they can.
So what does the hospice offer that hospitals and other healthcare organisations don’t?
“We work very closely with all our community and hospital colleagues but we are able to add a wealth of experience in looking after people with advanced illness, to focus on the issues at hand and issues ahead, both for the person and those who care for them,” said Dr Midgley.
“Our aim is to support people to live as well as possible despite their difficulties.”
Over this past year, Saint Francis Hospice, Havering-atte-Bower, has cared for 1,674 people living in Havering, Redbridge, Barking and Dagenham, Brentwood and West Essex.
The community services, who deliver 85 per cent of the care, and the hospice ward have been busier than ever since March, reflecting the higher need for support of people with advanced illness during the pandemic.
“A good third of our hospice admissions have come from hospital, with issues requiring more time and focus than the hospital is able to give,” said Dr Midgley.
“Usually for complex symptom issues and debility, but there may be very challenging social issues or severe spiritual or psychological suffering too.
“We can take the time to deal with these challenges in a professional but more homely environment.”
One of the biggest challenges the hospice faces is meeting increasing demand.
“We have a huge amount of need in our community,” said Dr Midgley.
“Over this past 10 years referrals have doubled, without expansion in staff size. Care has generally become more complex.
“Our care was once just cancer care, but now we support people with a much wider range of advanced life-limiting conditions, more people have multiple conditions, and more people are having treatments which in themselves are more complex and bring challenges.
Healthcare professionals in the community rely heavily on the hospice’s expertise and the hospice supports them through education.
“Our Pepperell Education Centre delivers high quality training courses so we are empowering GPs, district nurses, healthcare assistants and care home workers to feel confident and competent to deal with end of life care patients so we only need to help them with the most complex cases, “ said Dr Amsler.”
When the country went into lockdown, the hospice played a crucial role in relieving the pressure off NHS frontline services, and continues to do so.
“We have ensured that we step forward in these difficult times, to lift some pressure off the hospitals, ” said Dr Midgley.
“For example more hospice ward interventions like blood transfusions - short sharp interventions that can make a big difference to people.”
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The charity has maintained essential visiting all the way through the pandemic for those in crisis and for those who are dying, but has also had to step up the manning of its 24-hour advice line to meet the demand for advice and support to GPs, district nurses and others.
OrangeLine, its confidential telephone service, has expanded to keep connected to people who have re-stabilised but who remain vulnerable and who would normally come to the outpatient groups.
Volunteers have worked tirelessly alongside staff to keep contact going, and to ensure people are supported to come back to Saint Francis nurses if things are changing.
But with the charity receiving less than a quarter of its funding from the government and relying on donations to cover the rest of the running costs, Dr Amsler urged people not to take the hospice for granted.
“We are filling gaps that are not currently filled by other services but we are so established in the community that we could be taken for granted,” said Dr Amsler.
“There is a clear expectation that life will carry on as it is but the charity is struggling and unless something changes and people support us more, our valuable service could be at risk.”
Case study - Beverley and Margaret
Caring for a loved one at the end of life can be emotionally and physically challenging and it is an experience no one should have to go through alone.
Beverley Horne had been caring for her mother Margaret at her home in Hainault since the start of lockdown in March.
Margaret, 90, was diagnosed with ovarian cancer in 2018 and had managed well until her health started to seriously deteriorate in May.
Beverley, together with her cousin Vivienne, were initially able to look after her with the support of carers and district nurses, but it was only when Saint Francis Hospice became involved that Beverley found out about its Hospice at Home service and the difference the expert team could make at such a difficult time.
“When my mum came home from hospital, we knew it was not going to be a good outcome for her,” said Beverley, who worked as a manager in A&E at The Royal London Hospital, Whitechapel, before retiring in 2016.
“I’ve had a lot of experience in the NHS but it is very different when it is your own family and you do not know what to expect. Caring for someone seriously ill at home is very tough.
“The hospice helped us so much and what was so lovely was that we did not have to ring up to ask for someone to come, they would ring us every morning and ask if we needed someone to come out.
“The care was so personal. They would come and spend time chatting with mum and one of the ladies even massaged my mum’s feet and painted her nails.
“You just tend not to use these services because sometimes you think you don’t need them when actually you do.”
Beverley said the nurses and healthcare assistants from the hospice were a great emotional support for her and Vivienne and took pressure off them at a time when Covid-19 was also a real concern.
“On one occasion, a nurse asked us to pick up mum’s medication and we were able to pop out together because we knew mum was in safe hands,” said Beverley.
“It may seem like a small thing but we really appreciated it.”
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