When we talk about the specialist palliative care services provided by our Hospice it is easy to assume we are only talking about our Hospice Inpatient Unit. In fact,  a crucial part of the care we deliver is looking after those with life-limiting illnesses in their own homes.

In 2019 our Hospice@Home team delivered 19,432 hours of care to 120 patients. But what is Hospice@Home? And how has it worked during the trying times of the COVID-19 pandemic? 

Hospice@Home Coordinator Jean Kelly has been a part of St John’s Hospice since 1998 and is one of our longest serving staff members. Jean took time out from her busy day to talk to us about all things Hospice@Home. 

Delivering care at home 

One of the primary functions of the St John’s Hospice@Home service is to provide specifically trained Health Care Assistants to allow patients the choice to be cared for in their own home at the very end of their life. Up to 24-hour care if needed. Our team of skilled Health care assistants are available to provide all aspects of personal care (personal hygiene, toileting and feeding), as well as providing psychological support for families and carers. Hospice@Home is a highly responsive service and we take referrals up to 3 pm for care to start the same evening. All the professionals and hospitals who refer to us know that our Hospice@Home service will do our utmost to get patients home. 

Hospice@Home is essential 

When people are at their most vulnerable we recognise that  they want to be where they feel most comfortable. So Hospice@Home also aims to prevent unnecessary hospital admission, support a Hospital or Hospice discharge and provide respite for family members. We work throughout Central and West London and also part of Brent and have close relationships with other hospices, hospital teams, Community Nurse Specialists and Primary health care teams such as GPs and District Nurses.  

Allowing the family to rest 

When a loved one is terminally ill it often falls on the family to care for them. It can be incredibly exhausting for them at a time when they are going through emotional upheaval themselves. So sometimes we go in to care for someone to offer respite for the family. 

An example of this is when we offered night care for a family whose mother was awake and needing assistance most of the night. The family members were scattered throughout the country, each with their own health issues, and they were taking it in turns to come up and stay. The patient’s daughter rang me and said, “every time I rang you up, even though I knew you were busy, you never made me feel rushed. I knew I was asking you the same questions over and over, but you just answered them. You never made me feel as if I was being silly. It just made such a difference.”  It’s this reaction that we are always striving for. It meant the family could have a rest and rely on our carers without worrying. 

The demands of COVID-19

During the height of COVID-19 we had an increase in referrals for two key reasons. Firstly, hospitals wanted to free up beds for potential COVID patients and secondly, patients didn’t want to be in a hospital because of the increased chance of infection, knowing also friends and family couldn’t come to visit them. During the pandemic our caseload doubled. This has been an enormous challenge but one we have risen to. Frequent updates from Public Health England, some times every day meant working guidelines needed us to review our practice. We wanted to make sure the team were supported because they had concerns and worries so we brought them in for training and issued them with all the right PPE for their and the patients’ safety. 

We’ve had to adapt

Since lockdown started, the  Hospice@Home office team needed to be on-site every day. As our referrals increased we decided to recruit more staff. We took on another permanent member and another five bank workers (bank workers are freelance professional carers we call upon through a trusted agency when demand is too high for our permanent carers) which nearly doubled the team.  While all that was going on, we found ourselves having to do training as well as manage an ever-increasing caseload. The fact that we managed to achieve all of this under these circumstances is a true testament to the dedication of our team.

It’s not a rehearsal

In our line of work we know you often don’t get a second chance to get it right. As well as delivering care the team will often go above and beyond to ensure a patient has what they need and this makes a huge difference to someone’s ability to stay in the comfort of their own home. 

Our Hospice@Home care team is providing essential, free palliative care and keeping vulnerable people away from hospitals thereby lowering the chances of catching COVID. If you can spare anything please click this LINK to make a donation or call 0207 806 4040. Thank you.