St Clare Hospice: Caring on the Frontline during Covid: Hospice at Home

ST CLARE’S Hospice at Home team of registered nurses and nursing assistants provide free, specialist hands-on personal care in patients’ own homes to those approaching the end of life, or when families need additional support.

Every month the Hospice at Home team spends approximately 1,400 hours caring for people in their home, ensuring that patients, families and their carers receive compassionate care at the right time and in the right place.

The team has continued to work to support patients and their families throughout the coronavirus outbreak, adapting their service to ensure the safety of our staff, patients and their families at all times.

Q: What’s it like working on the frontline during covid?

A: I don’t class myself as a hero on the frontline; it’s my job to deliver holistic end of life care. This is something I’m passionate about, delivering compassionate care to people who need it.

Q: How has your role changed during covid?

A: It all feels a bit out of routine, but I guess that’s been the same for everyone. It’s changing now but initially it was very eerie when we’ve been going out and it’s been so quiet everywhere.

We are still delivering end of life care to everyone who needs it – regardless of whether they have Covid or not – everybody has a right to this care. As always, we just tailor this care to individual needs.

We’re just working differently. We’re starting our calls from our own homes, when setting out to visit patients, instead of from the office, we’re ringing in to hand over from our visits and we’re having our Team handover meetings on Zoom. It’s important that we still maintain this afternoon meeting where we talk about patient care, it means that if we have any concerns we can still discuss those together as a team. The other key difference is that we aren’t travelling together to visit patients. We are still caring for patients in pairs – wearing PPE, but we travel in separate cars due to social distancing.

It is a little bit different when you hold someone’s hand when they are dying with your gloved hand. But I will always hold their hand. The support and compassion is still there, even if there is a thin barrier between us.

Q: How has it affected patients and families?

A: Understandably people are more anxious about receiving care; it’s an anxious time for us all – in so many areas of our life at the moment. When we first enter a patient’s home we just try to reassure them and their families that although we might look a little differently we’re still there to support them. We just give them reassurance that we’ll look after them, and their loved ones, and support them through this difficult time. We listen to their concerns and do our best to meet their needs. It’s important that we give them space and time to talk about their fears and we always give them the opportunity to do this.

I remember when lockdown started I was visiting a patient who said to me ‘I know I don’t have long left and I know I won’t get to see my grandchildren again.’ She died 2 days later and I still wish that I could have just done that one thing for her.

It’s changed in other ways too – previously if I’ve been visiting a patient who was admitted into our Inpatient Unit usually I would pop by and see them while they are staying there, and talk to my colleagues on IPU to share some of my experiences of caring for the patient. I still share my knowledge, but I can’t do this in person and I can’t visit anymore which is a shame as I think it really helps to have recognisable faces around you, especially at this time.

Q: What have been the challenges of delivering care during covid?

A: One challenge has definitely been delivering care in PPE. Don’t get me wrong, I’m very grateful to have it, but it is very difficult to work in, especially on hot days. I’ve found that my glasses get steamed up when I wear the visor as well. But it’s not just that, the PPE definitely acts as a bit of a barrier for communication – especially if there is any hearing impairment for example wearing a mask where a patient might be used to lip reading. And it just feels more unnatural in terms of communication as well.

Sometimes families can feel more frightened too. I try to explain that we’ll still be there to deliver care, regardless of the symptoms.

I’ve found the isolation from the team to be difficult too. Where we travelled in pairs before we would reflect on things together in the car after being with a patient. We still do share our experiences but something is lost by not doing it immediately afterwards.

I know that our PPE keeps us, our patients, and their families safe, along with the other safety procedures we have in place – I’m constantly washing my hands – they’re ripped to shreds! And it always feels like my ears are about to drop off when I’m wearing the face mask because I have to have it on so tight.

Q: What has kept you going?

A: At the end of the day, it’s my job – to deliver compassionate care regardless of what’s going on or the symptoms our patients have got. I love what I do. I wanted to do this for a long time before I started with Hospice at Home. For me, if you can make someone more comfortable and support their family at such a critical time then it’s worthwhile.

Q: Have you encountered any #covidkindness since lockdown?

A: When I was out one day, two people were running and they just stopped and started clapping me and my colleague Denise. They said ‘well done, we think you’re amazing’ – it brought a tear to my eye!

Another time I was out with Denise there was a man, Neil Cody, who stopped us after we had just finished visiting a patient, he said ‘are you carers?’ We thought he was lost. We told him that we’re from St Clare Hospice and he explained that he made some visors and asked if we wanted some. We said ‘Yes please!’ He asked ‘How many do you want?’ and we said ‘as many as you can spare’. We couldn’t believe it, he gave me a full box full of visors! We were so shocked. And in fact I wore one today when I was caring for a patient, so thank you Neil!

Q: How important is it that people continue to donate to the Hospice?

A: I know that it is thanks to the generosity of kind people in the community that we’ve been able to carry on caring throughout Covid-19. People have been donating PPE to keep us and our patients protected but they’ve also contributed to our emergency fundraising appeal which has meant that we can continue with our much-needed service in the community. It’s what people deserve; everyone is entitled to good end of life care and if people can carry on thinking of St Clare in the coming months then we can carry on being there for people who might not have anyone else.

At the end of the day, it’s my job – to deliver compassionate care regardless of what’s going on or the symptoms our patients have got. I love what I do. I wanted to do this for a long time before I started with Hospice at Home. For me, if you can make someone more comfortable and support their family at such a critical time then it’s worthwhile.

Everyone is entitled to good end of life care; it’s what people deserve. If people can carry on thinking of St Clare in the coming months then we can carry on being there for people who might not have anyone else.

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