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Hospice at Home – your voice, your choice

Why have a Hospice at Home service?

Hospice at Home aims to offer additional support, alongside the community nursing, to allow people to stay at home and receive personalised high quality end of life care, as well as supporting those important to them.

When time is short, people should be able to choose the place they want to stay and receive the appropriate care and support. For most people this means being with people they love, in their own surroundings, where they feel more comfortable and peaceful.

Our team members, consisting of Nurses and Healthcare Support Workers, are here to support you from 07.00 to 19.00 hrs and will work collaboratively with the Community Specialist Palliative Care Team, Consultants and Community Teams in order to support you with what really matters, fulfilling your wish to stay at home.

What is Hospice at Home?

Hospice at Home is a service that aims to deliver personalised high quality nursing care in your own home, but as if you were at the Macmillan Unit.  This service supports not only patients, but families and those important to them.

It includes:

The provision of dedicated and specialist end of life care for those who wish to spend their last days of life at home.

The provision of planned and supportive visits to enable those living alone to be cared for in their chosen place.

The promotion of dignity and peace for those who are at the end of their life.

Access to advice from the Community Specialist Palliative Care Team on symptom control.

The provision of spiritual and psychological support for patients, families and those important to them.

Support for patients during difficult times, enabling them to stay at home and prevent a Hospice admission, where possible.

Many people have the fear of not being able to cope at home by themselves and that is why Hospice at Home was created – to support people who choose home as their preferred place to spend their last few days of life.

Who gives the support?

A team of dedicated nurses, who are qualified to offer specialised end of life care and provide support 07.00 to 19.00 hrs every day.

As well as providing personal care and symptom management, they will assist the families and the carers with emotional and psychological support.

Who is the service available to?

Anyone over 18 years old who have been referred to the Community Specialist Palliative Care team and who Is registered with a GP, living in East Dorset or Ringwood and are approaching the end of their life and would like to die at home.

How can the service be accessed?

Referrals to Macmillan Hospice at Home can be made by the Community/Hospital Specialist Palliative Care Nurses who are involved in your care.  Your or your family, GP and Community Nurse must be aware and agree with the referral as they remain responsible for your community care.

If a Hospice at Home referral is appropriate the team will contact you and/or your family and arrange a visit to introduce themselves, complete an assessment and decide on what care is available and what support would you require to remain at home.

Working with other services?

Throughout your care, Hospice at Home will work alongside the Community Nurses and GPs to improve end of life care and supplement the existing services.  That means we will establish a close communication with them, in order to maximise the quality of care provided.  The Hospice Palliative Care Team and Consultant will also be available for advice, if necessary.  Hospice at Home will be able to signpost patients to other services when appropriate.

List of pharmacies 

 Pharmacy name and address

Phone Number

100 hour pharmacy

 Locality

Asda Pharmacy

St Pauls Road, Bournemouth,BH8 8DL

01202 298900

Yes

Bournemouth East

Castle Lane Pharmacy
482 Castle Lane West Bournemouth, BH8 9UD

01202 772110

Yes

Bournemouth West

Ferndown Pharmacy
487 Ringwood Road, Ferndown, BH22 9AG

01202 892666

Yes

East Dorset

Tesco Extra Pharmacy
Yarrow Road, Mannings Heath Poole, BH12 4NX

01202 457447 or 01202 367447

Yes

Parkstone

Asda Pharmacy
West Quay Road, Poole, BH15 1JQ

01202 207000

Yes

Poole Central

Equipment – www.redcross.org.uk Is useful for wheelchairs and other equipment

Guide for people nearing end stage of life : https://intranet.rbch.nhs.uk/uploads/palliative/documents/What-to-Expect.pdf

Brief Drugs List for GPs

 

Pain/breathlessness:

Morphine sulphate 2.5-5mg SC PRN (10mg in 1ml injection)

(alternative if taking PO or eGFR<30 – Oxycodone 1 – 2.5mg SC PRN (10mg in 1ml injection))

[Please take background opioid into account when prescribing doses for anticipatories]

Anxiety/distress:

Midazolam 2.5-5mg SC PRN (10mg in 2ml injection)

Secretions:

Glycopyrronium 200mcg SC PRN (600mcg in 3ml injection)

(alternative for secretions: Hyoscine Butylbromide 20mg/ml injection)

Nausea :

Levomepromazine 6.25mg SC PRN (25mg in 1ml injection)

(alternative for nausea: Haloperidol 1.5mg SC PRN (5mg in 1ml injection)

Water for injection

Dexamethasone 3.3mg SC OD-BD (equivalent to 4mg PO) if risk of steroid withdrawal/Addisons during terminal phase.

Day/Time Example Timetable
Monday - AM

9am MMU Ward Hand over; 9:30am Tour of MMU

10m Consultant Ward Round, MMU

Monday - PM

12pm Ward Nurses - syringe driver administration (treatment room)

1:30 Nursing Handover – MMU (ward office)

MMU – Admission Assessment(s) with ward doctor

Tuesday - AM

9am Ward Hand over

9:20am Referrals Meeting on MMU

10am Community visiting with Specialist Nurse

Tuesday - PM

12:30 Journal Club – MMU (doctors office)

2pm Introduction to Patient and Family Support Team

3pm Introduction to Welfare and benefits Advisor

Wednesday - AM

9am Ward Hand over

9:20am Referrals Meeting on MMU

10am Consultant ward round - MMU

Wednesday - PM

2pm Doctor/Nurse Home Visit with Specialty Doctor

Thursday - AM

9:15am Multi-Disciplinary Team Meeting on MMU

Thursday - PM

2pm Introduction to Palliative Rehabilitation with Physiotherapist

3pm Introduction to Complex Discharge Planning in terminal illness

Friday - AM

Hospital Palliative Care Team Ward Visits

Friday - PM

2pm Introduction to Personalised Care Plan for the Last Days of Life with End of Life Care Nurse

4pm Debrief / sign off