Palliative Care Support Team

Patient Information Leaflet

Introduction

Your care will be supported by The Palliative Care Support Team. We are a team of specialist healthcare professionals working jointly with the local authority and other Health Care Professionals e.g. GP’s, Specialist Palliative Care Nurses, Therapists and District Nurses.

Your care is funded by Continuing Health Care (CHC) for 12 weeks. We will continue to assess your care during the 12-week period liaising with Health care professional and yourself.  During this period If your condition has stabilised your care will be transferred from the Palliative Care Support Team to another care provider.

Discuss your wishes with us

We would like to provide the best care and support possible for your loved one who are in the final stages of their illness, offering emotional and psychological support to you and your loved ones at a difficult time.

We provide a 7-day service, including Bank Holidays.

Our service visiting times are: –

• Morning: 7am – 12 midday
• Lunch: 12 midday – 2pm
• Tea: 3pm – 7pm
• Evening: 7pm – 10pm

Recognising dying

It can be hard to know when a person is entering their final days and hours. When we are looking after a patient who we believe is dying, and only have days or hours to live, we will explain this to you. You will be able to discuss any questions or concerns you have with these staff members.

We will discuss if it is possible, changes in physical health and decisions about care with the patient. However, the person who is coming to the end of their life may not be well enough to communicate. For this reason, the views of the family and friends are very valuable in planning and giving the best care to the patient.

Special Care

When we believe a person is dying, we want to give personal care that is specially tailored to their needs. Patients may have already considered what is most important to them. Please discuss this with us. The following are suggestions about things that are often described as important: –

Personal Care

Due to the rapid deterioration managing daily activities and tasks becoming difficult, and to allow comfort and dignity, this may involve putting in a hospital bed and other equipment for the safety of patients and staff.

Food and Drink

It is normal for someone who is dying to not want much food and drink, and so sips of water may be enough, providing they are able to swallow.

Mobility

Due to deterioration, mobility becomes more difficult as the patient has less energy. It is important for someone to maintain independence for as long as possible and we will assess on each visit. When providing all care in bed, good positioning is important, providing it is in the patient’s best interests. If you have concerns about how to help move or position someone, speak with your health care team for advice.

Elimination

A person who is close to death may lose control of their bladder and bowels. This can be helped by equipment such as incontinence pads or a catheter (a narrow, plastic tube that goes into the bladder)

Skin Care

As someone becomes less mobile or cared for in bed, this increases the risk of skin damage. Skin may become pale and moist, and hands and feet may feel cold. This will be assessed on each visit.

Mouth Care

Oral Health for patient comfort and dignity, it is an essential element of compassionate care. We will support with mouth care. You can moisten it to keep them comfortable. We advise the use of a baby toothbrush to gently clean the teeth and tongue.

Restless Moving

A person who is dying may become restless and agitated. This is usually caused by chemical changes in the body that affect the brain. This may be relieved by medications. Restlessness can also be caused by emotional distress. If this is the case, please discuss this with us.

Pain

Someone who is in the last days of life may not be able to tell us they are in pain. For this reason, we will look out for signs such as grimacing (screwing up their face), moving about as if they are in discomfort and sweating.

Breathing Changes

Their breathing may become fast and shallow or there may be long gaps between breaths. Occasionally, breathing may become noisy due to fluid collecting in their airways. Although this can be distressing to hear, it does not usually seem to cause distress to the dying person. We will monitor things closely and may contact other healthcare professionals.

Religious, spiritual, emotional and cultural needs

When someone is approaching the end of their life, they may find talking to someone can provide support and be comforting to them. Often this support comes from family and friends, but sometimes it helps to talk to someone who is not related.

Your loved one may wish to have any religious and spiritual needs supported by a representative of their faith. Please make this clear to us.

Medication

When a patient is believed to be dying, doctors will discuss whether the medication they are taking is still helpful. If swallowing medication becomes difficult, it may be given in a way that is easier for the patient, such as by injection.

A range of drugs will be prescribed that can be used if any troublesome or distressing symptoms occur, such as pain-relieving or anti-sickness medication. Sometimes patients are given a syringe driver which is a small, portable pump. This can be used to deliver continuous medication by injection day and night.

If at any time you are concerned that your loved one seems uncomfortable or distressed, please speak to a member of the team

The patient advice and liaison service (PALS) support patients, relatives and carers when they have concerns or queries Freephone: – 08000730510

If you have any questions, or if there is anything you do not understand, please contact the Russells Hall Hospital switchboard number on 01384 456111 and ask for the relevant department who issued this leaflet.

If you have any feedback on this patient information leaflet please email dgft.patient.information@nhs.net

This leaflet can be made available in large print, audio version and in other languages, please call 0800 073 0510.

Palliative Care Support Team September 2024 Version 2