End of Life Support

There will come a time when those living with a life-threatening illness must come to terms with the fact that the end of life is near.  The Hospice can offer much needed comfort and support at this upsetting and stressful time. It is not at all uncommon for people to find it impossible to think about practical issues at such an emotional period yet there are practical matters to be considered. Some of the key issues are explained in this section but a more detailed booklet is available on request.

Preferred Priority of Care

Preferred priority of care came into being in 2006. It is a nationally recognised document, which hopefully will ensure that patients are cared for in their preferred setting in the last weeks/days of life. Many people wish to remain at home but, in the past, have experienced difficulties when professionals came to the house and felt hospital was more appropriate.

People can complete the preferred priority of care document when curative treatment is no longer an option. The community healthcare teams have had training in how to complete the document so can help if necessary. The ambulance service recognise the document, so if they are called to the house by professionals and the family produce the document they will adhere to the person's wishes. In the event someone wishes to be cared for in another setting such as the hospice, bed availability has to be considered when the time comes.

The Inpatient Unit

There are many reasons why patients may prefer not to die at home and the Inpatient Unit may be able to offer supportive care at this time. While a bed cannot be guaranteed, the Day Service, Community, Inpatient and Hospice at Home teams work closely together, particularly at the end of life, to try to ensure that patient's preferences are respected.

Resuscitation

Resuscitation of patients at St. Helena Hospice can be a delicate and difficult subject to discuss.  Our whole philosophy is based on comfort. St Helena Hospice is only able to offer basic life support (CPR) in the event of a sudden collapse. Specialist treatment would involve transfer to the main hospital. Any decision reached about resuscitation will be in conjunction with Hospice senior medical staff and the patient, whose views, preferences and rights will remain at the centre of this process.  There will be consideration of information from carers regarding the patient's views and preferences. Advance Statements (or Living Wills) may be part of this discussion and there is further information about these in a separate information leaflet. Staff will be pleased to discuss any issues you might have.

Hospice at Home

It is recognized that most people want a good death, a tranquil, pain-free passing in their own homes among the ones they love. St. Helena Hospice provides a service that supports people at home at the end of life. This is intended to give patients and carers practical and emotional support so that a patient who wishes to die at home can choose to do so. The service is very flexible and aims to respond quickly to individual patient’s needs.

Referrals for the service are made through the Hospice or hospital discharge teams, District and Macmillan nurses or GPs and will be assessed by medical staff trained in palliative care. The Hospice at Home team members are trained and experienced in palliative care and can help you to maintain your peace and dignity.

FAQ - Will my GP still be involved in my care?

Your local doctor will continue to prescribe medication.  The Hospice at Home team is there to provide practical and emotional support and will work closely with the GP, district nurses and Macmillan nurse.  Any changes to care will be in consultation with the GP.

FAQ - Does the Hospice at Home team take over from the district nurse?

No.  The district nurse will continue to be the patient’s ‘key’ nurse and the Hospice at Home team co-ordinator will plan with the district nurse when any extra care is needed.

FAQ - How do I contact the team?

Once you are involved with Hospice at Home, the contact number can be found on the front cover of the district nursing notes or you can contact the team through the Hospice.