End-of-life care on the night shift

In the depths of the night when most of us are fast asleep in our beds, Senior Healthcare Assistant Adrienne is out and about providing vital end-of-life care to patients in their own homes across South Devon.  Adrienne is a member of Rowcroft’s Hospice at Home team that cares for patients at home in their last two weeks of life, and helps families to make the most of last precious moments. In this moving blog, Adrienne paints a vivid picture of how she provides compassionate care to patients, and enables exhausted loved ones to get desperately needed rest.

“Most patients, but not all, prefer to spend their last days in their own home, surrounded by the people they have known, their pets and all the usual smells and sounds. It is an incredible thing for a relative to care for a loved one at home, but it is also extremely physically and emotionally demanding. Watching someone you love – and with whom you have a lifetime of wonderful memories – deteriorate is hard. Add to that a whole new world of symptoms, diet, personal care, nurses and carers visiting, and being unsure what to do for the best, it is extraordinarily taxing. But with our support, those looking after their loved ones have time to rest to recharge their batteries – so that they can spend quality time together and make the most of every minute.

“The end of life can be a time of fear and uncertainty for families, when time is short and there is only one chance to get it right for patients. In my role, I arrive at the patient’s home at 10pm, talk to the patient and the family about the best way to provide care, and I am with the patient through the night. I attend to their needs so that the family can rest and go to bed feeling confident that their loved one is in good hands.

“My nights are driven by the patient’s needs. I help take care of personal care needs and I may help the patient to drink or get comfortable. And some patients may want to talk. When I visit a patient, I take with me some basic necessities including oral sponges, artificial saliva gel, barrier creams, cleansing wipes and various pads and incontinence supplies. That way I am sure to have everything I may need to make sure the patient is comfortable through the night without disturbing the family.

“Generally, as people become more poorly and the end is closer, they may spend most or all of their time asleep. In that case, it is my responsibility to make sure that they are repositioned regularly, every three to four hours throughout the night. If this doesn’t happen, they can quickly develop pressure damage which can be very painful, but with good care this can generally be avoided.

“For myself, I always take a hot water bottle with me (as sometimes it can be very cold during the night), some milk and teabags to keep me going, and my knitting. I usually spend quiet times knitting cat blankets for the RSPCA. The cats don’t mind if you make a mistake knitting in low light!

“I have access through the night to support from my team – who can come and assist me if needed, for example, if the patient is in pain, distressed or anxious, or requires further medication, or if the patient is too large for me to move them on my own.

“Should the patient’s condition worsen and the end looks in sight, I call the family members in case they wish to attend. Predicting the end isn’t always easy, but in most cases we are able to get families together as the end comes. If people are alone in life, then I provide compassionate care and I sit with them as they leave this world.

“If the patient has been poorly for a long time, there can be a sense of relief that all the patient’s struggles are behind them. For other families, the patient may have been very recently diagnosed with a terminal condition and the sense of shock and grief is very raw. It is easy to think that all our patients are older people, but that is far from the case and sometimes there are younger children in the house who have to get to grips with the loss of a parent.”

Adrienne and the Hospice at Home team care for around 440 patients across South Devon each year. While the team do all they can to support as many families as possible, demand for their service has grown considerably through the pandemic. Through the Hospice at Home Appeal, Rowcroft hopes to raise more funds to recruit more nurses and healthcare assistants, to care for more families across the region.

“I am proud to be part of the Rowcroft Team that delivers excellent care at home and that works well with other teams across our area to provide an integrated service for patients and the people that love and care for them,” says Adrienne.

Rowcroft’s Hospice at Home Appeal aims to raise vital funds to expand our Hospice at Home service. For more information about the appeal or to make a donation, please see our Hospice at Home web page or telephone: 01803 217450.

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