Transcript Slide 1

National
Homecare
Conference
Anne Willis
Hospice Manager :
Marie Curie Hospice :
Edinburgh.
The Role of Hospice Care.
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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.
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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’
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What is the aim of a Hospice ?
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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 .
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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.
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Services in last
weeks or months
of life.
Associated with
dying limits
acceptability .
Resource
constraints .
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8,000 each year
¼ cancer
1/3 dementia/frailty
1/3 organ failure
1/12 sudden
>50% in hospital
Activity Tells a Story .
07-08
08-09
Admissions
394
456
Discharges
215
228
Deaths
326
362
CNS Visits at
Home.
2372
2561
Cancer Care : Inpatient Care
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“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.
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‘ I take one step
forward and then
two steps back ‘
I’d like to get
better , but I keep
getting a bit
worse.
Comradeship
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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 .
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Complementary
therapies for carers
and patients .
Support for Carers
at Home ,- respite
and befriending .
Palliative care
workshops with
VOCAL
Hospice in the Community
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Raising awareness
about death , dying
and grief.
Bereavement care.
Involving and
engaging with local
organisations.
Frailty and Dementia
Focus on Care
Homes .
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Advanced care
plans even earlier .
Pain Assessments
Education.
EOL conversations
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The Role of Hospices : End of Life
Care at Home
Working with GP ‘s to
review Palliative Care
Registers.
Clinical systems
development .LCP ,
DNAR , Pain
Assessment , OOH
Communication.
Advice and Review of
Specific patients at
home or in
Outpatients .
Carers Support.
Allocated Care Homes
, end of life care
planning , education
and modelling of best
practice.
Aiming to Equip Other
Professionals
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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.
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Philp I ( 2003) End of Life Care for Older People. European
Journal of Palliative care ,10 (4) : 151-153.
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www.mariecurie.org.uk/dementiaproject2009.
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http://www.scotland.gov.ukliving and dyingwell