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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.


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The Role of Hospice Care.

  • What do Hospices do?

  • Current challenges for Hospices .

  • The role of Hospices in end of life care at Home.


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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.


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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’ ,


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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 .


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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


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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



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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.”


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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.


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Comradeship Services.

  • We are all in this together , so lets talk about it.

  • Psychological and spiritual support.

  • Skype/ Blogging your cancer friends .Linking to Maggies Centre.


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Comfort for Carers . Services.

  • Complementary therapies for carers and patients .

  • Support for Carers at Home ,- respite and befriending .

  • Palliative care workshops with VOCAL


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Hospice in the Community Services.

  • Raising awareness about death , dying and grief.

  • Bereavement care.

  • Involving and engaging with local organisations.


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Frailty and Dementia Services.

Focus on Care Homes .

  • Advanced care plans even earlier .

  • Pain Assessments

  • Education.

  • EOL conversations .



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Aiming to Equip Other Professionals Services.

  • 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.


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References. Services.

  • 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


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