Hospiscare is a charity that provides end of life care in Exeter, Mid and East Devon. We care for patients with any type of life-limiting illness – whether on our inpatient ward, in our three day hospices or through our community nursing teams.
We believe that dying is an important part of living, so, for us, the needs and wishes of patients and those close to them are incredibly important. We know that the majority of people, given the choice, would like to die at home. But sadly this isn’t a reality for most people – whilst 81% of people in Devon say they’d like to die at home, only 24% actually do. At present, our community services enable 42% of our patients to die at home; we’re proud of what we do, but we knew we could do more to help people have that all-important individual choice over the end of their lives.
That’s why we launched the Hospiscare@Home service in 2015. In the last year, through the support of Hospiscare@Home, we were able to support 96% of patients to die at home. It’s an achievement that we’re absolutely thrilled with, made all the more meaningful by being recognised by the Markel 3rd Sector Care Awards for outstanding end of life care. The judges were particularly impressed with how we provide true individualised care for patients and their families at the end of their lives.
How we do it
The idea behind Hospiscare@Home is to provide a complete package of end-of-life nursing expertise, advice and support 24-hours a day, 365 days a year – all in the patient’s home. Our work is all the more vital because we are the only provider of 24-hour end of life care in people’s homes in these areas.
The service is provided by registered nurses and healthcare assistants, with support from our clinical nurse specialists and specialist medical consultants.
Our clinical staff work closely with each patient’s GP to meet medical and pain management requirements; they also consider the social, psychological and spiritual needs of each patient and that of family members. Our staff can also help with general care, including washing and dressing, plus remedial massage and other support.
We were also commended by the Markel 3rd Sector Care Awards judges for the kind manner in which we work alongside our communities, and the support we receive from them in return is brilliant. Our amazing supporters and charity partners – Seaton & District Hospital League of Friends, The League of Friends of Axminster Hospital, Exmouth & Lympstone Hospiscare, and Budleigh Salterton & District Hospiscare – raise money to fund the service in their respective areas.
‘It’s so important to have the choice’
The founder of the hospice movement, Dame Cicely Saunders, said, ‘You matter because you are you, and you matter to the last moment of your life.’ It’s a quote we wholeheartedly embrace. For us, Hospiscare@Home is an important way to allow people to be themselves, away from a clinical environment. In the home setting, you really get to know people. Hospiscare@Home nurse, Liz says, ‘It gives you a deeper understanding of the real person, and that allows you to give complete, holistic, focused care. Wanting to give all-encompassing support is the reason many of us become nurses in the first place and I wouldn’t want to do anything else.’
Gwennie’s husband Keith was supported by the Hospiscare@Home service in 2017. Keith spent time on our inpatient ward in Exeter, but was keen to return home to his family as soon as possible. As Gwennie put it, ‘Being home seemed to revitalise him. The Hospiscare@Home team would come in and do all the treatments. It all came to us.’
At the heart of Hospiscare@Home are the connections we make with patients and their families. Gwennie told us, ‘Keith got on so well with the team. He really looked forward to the girls coming over. We had such good banter with them, we were always laughing and one of the nurses was always singing.
‘When he died, I called the Hospiscare@Home team. Keith wanted to be buried in his motorbike gear, full leathers, gloves, boots and with his helmet by his feet, and the nurses helped me do this. I don’t suppose I should say it, but there were comical moments. We couldn’t get one of his gloves on properly, but together we did it, just as he wished.’
We do everything we can to help someone have a good death – and being part of that is always a huge privilege. In Gwennie’s words, ‘Enabling people to die at home, to give people that choice, is invaluable. The nurses are experts; their help and advice is second to none. Anytime I needed them 24/7 they were there, like part of the family. It’s so important to have the choice to stay at home – no-one wants to be away from home.’
It means a lot to us to have all the hard work, commitment and compassion that’s gone into Hospiscare@Home recognised by the Markel 3rd Sector Care Awards – but we’re not stopping here. We are all living longer on average, and Devon in particular has a large older, rural population and many single-person pensioner households. Combine that with the recent halving of community hospital beds throughout our focus area, and it’s clear that demand for in-home end-of-life care will only continue to grow.
We know our model works, so we’re hoping to roll out Hospiscare@Home throughout our focus area in coming years so we can enable everyone to have the choice to spend the end of their life as they choose.
The Markel 3rd Sector Care Awards is run specifically for the voluntary care and support sector. Nominate today to be in with a chance of your project featuring in an issue of CMM. Enter for free now . Sponsorship opportunities are also available.
With thanks to our supporters: National Care Forum, Learning Disability England, The Care Provider Alliance, Association of Mental Health Providers and VODG.
The End of Life Care Award was sponsored by Boots.