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National Homecare Conference . Anne Willis Hospice Manager : Marie Curie Hospice : Edinburgh. . The Role of Hospice Care. . What do Hospices do? Current challenges for Hospices . The role of Hospices in end of life care at Home. . Hospices World Wide. .
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National Homecare Conference Anne Willis Hospice Manager : Marie Curie Hospice : Edinburgh.
The Role of Hospice Care. • What do Hospices do? • Current challenges for Hospices . • The role of Hospices in end of life care at Home.
Hospices World Wide. Now 7,000 Hospices in over 90 countries. In Europe largest number are in Poland 246 , France, Germany and Sweden. In Scotland 19 Adult Hospices , 2 Childrens Hospices . 13 are independent voluntary organisations supported by their local communities. Health Boards provide £13 million. 40% of Hospice Running Costs. All Hospice care is Free.
The Hospice Movement. • Started with Dame Cicely Saunders who founded the first Hospice in the UK. • Dedicated to patients with cancer and the concept of ‘What is in your mind and in your heart’ ,
What is the aim of a Hospice ? • Optimise quality of life before a timely , dignified and peaceful death . • A place for comfort, care and support. • Lead and Influence the development of palliative care services locally and nationally. Scottish Government Action Plan : Living and Dying Well . • A local resource , supported by the community .
REFERRAL • Patients with advanced, progressive or incurable disease who need palliative care. • Patients in any setting, home , hospital or care home. • Telephone advice, a single assessment or a period of specialist care . • Referral for any patient who has complex end of life symptoms, uncontrolled pain or other symptoms, complex, physical, psychological , spiritual or family needs that cannot be met by the existing team. • Palliative Care Guidelines • Any health professional in discussion with GP
The Challenges. • Services in last weeks or months of life. • Associated with dying limits acceptability . • Resource constraints . • 8,000 each year • ¼ cancer • 1/3 dementia/frailty • 1/3 organ failure • 1/12 sudden • >50% in hospital
Cancer Care : Inpatient Care • “After eight days, I was able to return home,and my wife and I went on holiday up to the north of Scotland. Sitting next to beautiful Loch Linnhe, we felt so relaxed, and had a lovely week.”
Social and Psychological Support: Day and Outpatient Services. • ‘ I take one step forward and then two steps back ‘ • I’d like to get better , but I keep getting a bit worse.
Comradeship • We are all in this together , so lets talk about it. • Psychological and spiritual support. • Skype/ Blogging your cancer friends .Linking to Maggies Centre.
Comfort for Carers . • Complementary therapies for carers and patients . • Support for Carers at Home ,- respite and befriending . • Palliative care workshops with VOCAL
Hospice in the Community • Raising awareness about death , dying and grief. • Bereavement care. • Involving and engaging with local organisations.
Frailty and Dementia Focus on Care Homes . • Advanced care plans even earlier . • Pain Assessments • Education. • EOL conversations .
Aiming to Equip Other Professionals • Better assessment and management of pain . • Importance of advanced care planning versus ‘ striving to keep alive’ • Recognising dying ,- taking responsibility and promoting importance of end of life decision making . • Promoting an outlook on death and expectations which relate to reality to prevent unnecessary admissions or aggressive treatments.
References. • Philp I ( 2003) End of Life Care for Older People. European Journal of Palliative care ,10 (4) : 151-153. • www.mariecurie.org.uk/dementiaproject2009. • http://www.scotland.gov.ukliving and dyingwell