care and support for the terminally iLL
Whether you are looking for a full-time live-in care or periodic visits, at Classic Health Care Solutions we provide a full range of services for palliative care that follows the national palliative care guidelines . Our support covers all aspects of care including personal care, pain management, administering medication, cooking meals and companionship.
We work alongside hospices, support groups, Continuing Health Care Teams and District Nurses. This enables us to offer the right level of home care for both service-users and family alongside other elements of your care plan.
Palliative Care at home can involve:
- Support with activities of daily living such as personal care needs with bathing, dressing and toileting.
- Continence care, whether it is changing continence pads or managing a stoma or catheter.
- Medication support including prompts or administering medication.
- Support with pain management.
- Help with mobility, moving around your home, whether it is with assistance of one carer or with the support of aids such as being hoisted for transfers or other moving and handling aids.
- Housework duties such as vacuuming, dusting, changing beds or doing the laundry
- Preparing meals to your tastes, and washing up afterwards
- Running errands to collect prescriptions or food shopping
- Companionship and supporting your independent living at home
Palliative Care Guidelines
Palliative care guidelines were created by the National Institute for Health and Care Excellence (NICE), the palliative care guideline details how someone within the last few days of their life should be cared for. The guideline is centred on:
- Planning end-of-life care with the individual, their family and healthcare professionals.
- Recognising when someone is in the last days of their life.
- Staying comfortable – physically and emotionally
The focus of the guideline is very much about maintaining the dignity and comfort of the individual and involving them as much as possible with their care plans.
What is NICE And what do they do?
The National Institute for Health and Care Excellence (NICE) was created in 1999 as a national body dedicated to improving health and social care services across the UK. They create evidence-based recommendations and guidelines for healthcare workers and practitioners to carry out the very best care, including within the NHS and private care services. They are committed to the highest quality standards across health and care services, carrying out research and working closely with the government, GP surgeries, hospitals and local authorities.
what are the main palliative care guidelines?
Published in 2015, the NICE palliative care guideline is centred around the individual and their family. There are four main recommendations in the palliative care guideline:
Where possible, it is important that the individual is involved with their end-of-life care plans. They should be included in all conversations regarding what will happen, and their wishes should be adhered to – for example, if they want to die at home without any further medical treatment or if they have particular religious requests. If a person is unable to make these decisions due to capacity, their Power of Attorney should do this on their behalf.
recognising when someone is coming to the end of their life
If someone has a terminal illness and begins to decline, they should be closely monitored for symptoms that show they are in the last days of their life. They should be assessed on a daily basis as to whether their condition has worsened or improved. If they are deemed to be at the end of their life, this should be fully explained to both the individual and their loved ones. Sharing all or limited details is at the discretion of the individual and their care team.
There are a variety of symptoms that should be closely monitored when someone is receiving end-of-life care. They are:
- Pain – this should be limited as much as possible and treated with the most appropriate pain killers or relief.
- Breathlessness – this can be related to the individual’s primary health condition or a side-effect of their condition. This should be managed effectively with pain relief or appropriate treatment.
- Nausea and vomiting – usually a side-effect of treatment or related to their primary condition. Medication can be used to help or may have to be reduced if it’s causing nausea and vomiting.
- Anxiety and delirium – can be common for those in the last days or hours of their life. This can be treated with medication or reduced by having the comfort of familiar loved ones around them.
- Hydration – dehydration can occur for those near the end of life. If they are able to and want to, the individual can have support with drinking or a fluid drip if swallowing is difficult. Oral gels and saliva replacements are also available to ensure those who are unable to swallow are comfortable.
The person’s existing medication, any new medication required and how medicine is administered should all be considered for end-of-life care. Those receiving care at home, there may be anticipatory drugs that are provided in advance of the symptoms deteriorating. These can be administered quickly and limit discomfort should extra medication be required at a later stage of care.