BackgroundIn 2014 the WHO declared that ‘early palliative care not only improves quality of life for patients but also reduces unnecessary hospitalisation and use of health care services’. Following an audit in 2014 the Contact Centre at our hospice were aware that there were a number of patients who would benefit from our services but were either declining the services or being declined due to not being able to meet the criteria for specialist palliative care and end of life care.AimsTo develop an early palliative care service which allowed the patients and families/carers to experience a modern hospice approach of living well and palliative reablement. This included:· Advance care planning· Early support for families and carers· Networking with other agencies e.g., CAB, carers support· Live well approach· Opportunity for referral to hospice services to prevent crisis e.g., 24 hour advice line, H@H· Psychological support.Methods· Outpatient style appointment at an Outreach Centre close to home at the patient’s/family convenience with a named nurse.· Patient centred approach· Referral to other internal and services· Flexible approach to use of hospice services.Results· Significant increase in the number of patients/families gaining access to hospice services· Extension of lighter touch services· Increase in referrals of non-cancer and long term conditions· Positive feedback from patients/families· Earlier referral for some patients to complex specialist services· Development of the nursing team’s skill mix· De-stigmatises hospice care.Conclusion· Further investment in the early referral services as patients and families/carers are utilising living well and palliative reablement services· An opportunity to encourage end of life conversations and advance care planning for patients with dementia· Potential to extend into GP surgeries/satellite clinics to reduce anxiety around being referred to a hospice· Potential to extend into outpatient services at local hospitals to support patients who are newly diagnosed as palliative.
BackgroundAdapting the principle that ‘care for one another at times of crisis and loss is not simply a task solely for health and social services but is everyone’s responsibility’ (Kellehear, 2015) and a need to find cost effective methods of delivering more support to more people; an innovative model of ‘drop in support’ was developed.Aims of the ModelA ‘light touch’, coaching style of group facilitation has been developed to enable anyone affected by the diagnosis of a life-limiting illness to develop coping strategies and in turn support othersTo provide a safe setting for anyone affected by the diagnosis of a life-limiting illness to meet weekly in a supported and facilitated environmentAttendance will be open to any individual who is affected by a life-limiting illness, be they a ‘patient’, ‘carer’ or someone bereaved.ResultsPeople with lived experience of illness, caring and grieving are supporting one another with compassion, requiring little ‘professional’ intervention. The cost to facilitate these sessions to such large numbers is a fraction of those usually associated with a traditional hospice day care. Attendance every week is in excess of over 40 people and three new groups have been set up in two new centres to meet increasing demand. Outside of the ‘group’ setting, self-sustaining local support networks have been established and shared, decreasing reliance on traditional public services. The model of coaching, empowerment and self-sustainability can be demonstrated by the addition of a new volunteer facilitator who originally joined the group two years ago as a bereaved widow.ConclusionBy creating a safe space and nurturing a compassionate community approach, people are creating their own networks of support and in turn decreasing their reliance on the health and social care system.
significant improvements to their quality of life. All of which have been captured through robust quantitative and qualitative outcome measures.
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