Saturday 24th December 2016

Everyone has the right to decide where they want to spend the end of their life. Some people have a fear of dying in unfamiliar surroundings, so it is good to be able to support patients and families who choose to stay at home.

I work closely with the community team, GPs and hospice staff, especially with the clinical nurse specialists. I care for patients who have a life-limiting illness nearing the end of life, assisting with personal care, and emotional and psychological needs within the home.

My shift pattern is 8am to 4pm or 12pm to 8pm, covering the whole of mid Essex. When I started I wasn’t sure how I would get on with finding patients’ houses as my sense of direction is quite bad - thank goodness for sat nav! I use the time between patients to process whatever has happened during the visit, be it quietly thinking, chatting to a colleague about the experience or singing my heart out to the radio.

A good day for me is when I know that we have made a difference by our visit. Whether big or small, a lovely smile from a patient or a hug from a relative is a very special gift.

First visit

We call on this patient twice a week to assist with a shower. We chat for a while about their family and they talk openly of their illness and expectations for the future. We are shown photos of her children and grandchildren and hear what they are all up to. She has spent the weekend making a memory box for her children, she said she had found it hard but feels at peace now she has done it and she hopes in the future it will help them all come to terms with what has happened. Conversations like this are not easy but I count it a privilege to sit beside this lady on her journey. As we leave, she is showered, dressed and sitting on her bed with a cup of tea. Her smile says it all.

It is good to talk about normal everyday things as well as their illness. It can feel all-consuming living with an illness, and patients and families seem to appreciate a diversion for a little while. It is impossible not to be affected by situations when working in palliative care, but our job is not all doom and gloom, it is about trying to make a bad situation a little bit better. When people ask me where I work it is usually a conversation stopper, as people don’t really know what to say. It is a very rewarding job and helps you keep grounded and remember what is important in life.

Second visit

As we are on our way we have a phone call to say the patient has passed away but the family would still like us to visit. The family ask that we make sure their loved one is clean. When we’ve finished we ask the family if they would like to pick a flower from the garden to place on the pillow. As well as offering practical care, our role is also to support the family through this period and offer them support, advising them of the Bereavement Support Service that Farleigh offers.

Third visit

This gentleman lives on his own and he has lived here all his life. It is important to let patients keep their independence. He has always been very active and he is reluctant to accept any help with personal care. He talks freely about his illness and today is ready to accept our help as he has deteriorated and has become weak and breathless. He is feeling very low; we sit with him while he tells us he wishes to die in the hospice. Sometimes people just need a hand to hold, and for someone to listen to things they feel they can’t say to their friends or family.

End of the day

Now it’s back to base to write up our notes. We also have a debrief, discussing and reviewing the mornings events, and preparing ourselves for our next visits. Whilst visiting patients, the Hospice at Home team assess the situation to make sure families are aware of all the services we provide and make onward referrals to other teams when needed. I am fortunate to work with a very close team, I am continuously learning within my role and expanding my knowledge of and skills in palliative care. I have learnt so much during my time at Farleigh and I truly love coming to work.

Janice Allen, Healthcare Assistant

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