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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

National Homecare Conference

Anne Willis

Hospice Manager :

Marie Curie Hospice : Edinburgh.

the role of hospice care
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
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
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
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 .
  • 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
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
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
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.
  • 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
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
Hospice in the Community
  • Raising awareness about death , dying and grief.
  • Bereavement care.
  • Involving and engaging with local organisations.
frailty and dementia
Frailty and Dementia

Focus on Care Homes .

  • Advanced care plans even earlier .
  • Pain Assessments
  • Education.
  • EOL conversations .
aiming to equip other professionals
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.
  • Philp I ( 2003) End of Life Care for Older People. European Journal of Palliative care ,10 (4) : 151-153.
  • and dyingwell