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Caring for someone at home
You may not need to move away from home to receive care, your GP can arrange for community nurses and/or carers to come to your home and provide personal or nursing care for you there. Some people may also need support from the community specialist palliative care nurses, community matrons, or other specialist teams.
Various teams work closely together to:
- provide or arrange hands-on nursing or personal care, if required
- advise on pain and symptom control
- provide practical and emotional support for you and your carers at home
Who does what?
Carers
If you have agreed to a ‘package of care’ this is will be provided by carers or health care assistants who will visit your home, sometimes in pairs, to deliver personal care such as help with washing, dressing or repositioning you in bed. There may be between one and four visits a day depending on your needs and in exceptional cases there may be night sitters
Community and district nursing team
The team consists of registered and unregistered nurses who work closely your GP surgery. They will visit when you have health needs that require nursing care such as assessing your symptoms, having a pain-relieving injection, putting up a syringe driver, changing a catheter or dressing a wound. The nurses are all contacted via Bodmin switchboard on 01208 251300.
GP
When you are returning home for end of life care, or caring for a relative, your local surgery plays an important role. They will work with your district nurses and specialist palliative care nurses to prescribe medication, they may visit you to complete a medical consultation, or complete paperwork which will support formal processes once someone dies.
Specialist palliative care (SPC)
This service consists of nurses or doctors who are experts in supporting patients with advanced incurable illness and their families. Patients are referred if they have difficult to manage symptoms, or have complex psychological or social problems. They will listen to you to assess how your illness is affecting you, and make recommendations about your medicines, or your care.
Out of hours (OOH) treatment for patients with palliative care needs
This service provides GP support to patients with palliative care needs at weekends and overnight when your usual GP may be unavailable. You are encouraged to ring if you have symptoms such as pain or nausea which do not settle with your usual medication. Your call will be prioritised and one of the doctors or nurses will ring you back. Call 01872 224050.
Caring for someone in last days of life
People who are approaching the end of their life are entitled to high-quality care, wherever they’re being cared for.
Good end of life care is tailored to the person who needs it. The individual and the people close to them should be at the centre of decisions about their care.
It helps if the individual’s wishes are written down as a personalised care plan and, if the individual agrees, that this can be shared with the people involved in their care now and in the future. It’s important the care plan is reviewed regularly so that it stays up to date as situations and wishes change.
Please view the links below for more information:
Managing symptoms
Managing symptoms, including pain, is an important part of end of life care.
Each person will have different symptoms, depending on their condition and the kind of treatment they may be having.
Symptoms can include feeling and being sick, constipation, loss of appetite and pain.
Your doctor, nurses, and wider care team will help you manage your symptoms and feel as comfortable as possible. If you would like more information about managing your symptoms, the NHS managing pain and other symptoms’ page has lots of useful information.
Support for carers and self-care for carers
Below is a brief description of the services Cornwall Hospice Care Community Services offer along with a comprehensive list of local and national support available to you and those important to you. Visit the links below to read more information on how to access these support services, including help self-help.
Useful Links Directory – Self Help
This is a comprehensive database of local and national support available to you, with links and contact information for a range of organisations and charities, including Bereavement & Grief, End of Life Planning, Cancer & Oncology, Mental Health, Financial, Children & Young People, Neurological conditions and many more.
Useful Links Directory – Cornwall Hospice Care
Neighbourhood Hubs – Support for Palliative Patients and their Carers
The Neighbourhood hubs offer occupational therapy and physiotherapy one-to-one appointments. This can be face-to-face or over the telephone by video call. Our hub therapists can help with a range of issues, such as shortness of breath, mobility problems, falls, fatigue, anxiety, and practical issues in day-to-day living. They complete a full assessment and focus their treatment on what is important to you.
Initial referrals for the Neighbourhood Hubs are accepted from Health and Social Care professionals, but also take referrals from you or your carer as well. You may be referred if you are 18 or older and live in Cornwall and have been diagnosed with a palliative or terminal illness or advanced progressive disease – in other words, those whose condition has been determined to be for palliative management, who may be transitioning from active treatment to palliative care, who have severe or end-stage disease; or who have an advanced progressive condition. This includes diseases such as cancer, heart disease, neurological diseases, and lung disease as well as other terminal illness.
Find out more about Neighbourhood hubs (Cornwall Hospice Care).
Living Well Workshops – Support for Palliative Patients and their Carers
Find a Living Well Workshop. These cover topics such as:
- Fatigue Management
- Anxiety & Stress Management
- Breathlessness Management
- Advance Care Planning
- Soothing the Mind
Living Well Groups – Support for Palliative Patients and their Carers
Groups include:
- Gardening
- Wellbeing
What Matters? E-Newsletter
An E-newsletter for those in Cornwall approaching or planning for end-of-life and bereavement. You can find the What Matters e-newsletter by scrolling down the Cornwall Hospice Care self help resources page.
Cornwall hospice care community services’ team produce a bi-annual electronic newsletter publication for those who are approaching or planning for end of life and those who are bereaved in Cornwall. It is aimed at patients, service users and the public as well as other health and social care professionals.
Self Help – Community sharing space
For those wishing to connect on-line via social media channels, please head to the Community Sharing Space on Facebook. It’s a public group available to anyone wishing to join and is there for people who are bereaved, feeling socially isolated, carers and those coping with a long-term illness.
It’s a space for:
- Support, signposting, and information
- Well-being activities and events
- Bereavement support
- A place to share experiences
- General well-being
Financial advice
Money worries can occur if you or someone important to you needs to take time off work as a result of illness or to care for someone at the end of their lives. The NHS ‘Coping Financially’ website has lots of useful information, help and support. Please see the Coping financially page on the NHS website.
Discharge from hospital
During the time that your relative is in the hospital their care needs will be assessed to identify the level of support required to leave the hospital. This is a joint venture that will include the occupational therapists and ward nurses, it may also include the Marie Curie in-reach discharge coordinators or the specialist palliative care team. The team should work closely with you, and your relative to understand you shared priorities.
Every social circumstance is different. Some patients may have significant needs that require a nursing home placement, or hospice care. Others may be able to return home with personal care provided at points during the day, what is called a ‘package of care’. It is important to work together to identify what is most suitable or your individual family. Below is a list of suggested useful actions:
- Make the ward team aware of any lasting power of attorney.
- Identify a nominated family member who can best support the patient in decision-making, or for patients who lack mental capacity a family member who best represents the views of the patient and can liaise with the wider family
- Make the ward team aware of any care the family are able to provide. Waiting for large packages of care can sometimes delay discharge.
- If the family are providing all of the care speak with your Community nursing team to obtain a care box containing supplies to support continence and personal care.
- Identify family or friends who may be available to take delivery of equipment or move furniture to accommodate a hospital bed.
- Ring the patients GP to ensure that they are aware of the patient’s discharge. It may be helpful to arrange a home visit.
- If the patient is being discharge for end-of-life care, check that they are being discharged with injectable medication for symptom control.
- Have a notepad and pen available for questions that arise and to write down important information.
Follow the links below to find out more about being discharged from hospital and caring for someone at home.
NHS Continuing Healthcare
NHS continuing healthcare, also known as fully funded NHS care, is free care outside of hospital that is arranged and funded by the NHS. If you are eligible for NHS continuing healthcare, NHS Cornwall and Isles of Scilly will fund the care needed to meet your identified care needs. Eligibility does not depend on a particular disease, condition, or diagnosis. Nor does it depend on where the care is provided, or by whom. If an assessment determines that you have a primary health need, you may be eligible. If you are not eligible and you have social needs, you can apply for help from Cornwall Council or the Council of the Isles of Scilly. The Cornwall Care Services directory can direct you to services that could help you more.
You can find more information here about NHS continuing healthcare or adult social care.
Page last reviewed: 8 January 2024