Author: Rosee Swift, Registered Nurse, Wellbeing at Home Coordinator
Date: July 2024
The Wellbeing at Home Service brings our range of bespoke and personalised wellbeing care and support into your own home.
Monday
My week starts with catching up on our most unwell patients, so we can prioritise our support to them.
Our Hospice at Home Team let us know if a patient’s health has declined and if they are needing more symptom support. Or sometimes a family asks for extra support during the day because they are exhausted emotionally and physically.
Looking after someone dying at home is not easy. Today, a visit has been cancelled because family are now visiting to spend final days with their loved one.
Ensuring patients have continuity of care
I enjoy planning this continuity of care delivery. We endeavour to provide support using the fewest number of our team to help build therapeutic relationships.
I take a phone call from a patient’s wife wanting some reassurance. She is feeling guilty about her emotions around her husband’s diagnosis. I have signposted her to our drop-in Wellbeing Café on a Thursday. Here she can receive emotional support and further discuss sources of support for her.
There’s a call from a patient’s daughter to ask if we can arrange a Wellbeing at Home visit for her dad. This is so that her Mum can have a much-needed break from caring.
The importance of staff wellbeing
I monitor the Wellbeing at Home team throughout the day to ensure all staff have safely arrived and departed after their home visits.
The nursing team let us know if they have concerns about the person they have visited and have requests for District Nurses or GPs to do follow-up visits. Or we refer to other Treetops teams for care and support.
We’ve had three new referrals during the day, and I begin to review our patient waiting list. I end the day by provisionally booking visits for the next few weeks.
Tuesday
We start the day by reviewing the previous days visits and then put our heads together about planning future patient visits. This includes looking at each patient’s needs, their carer’s needs, and other factors including geography.
It's the part of the job when I imagine we should have little cars on sticks and move them around the map, plotting out the most effective route for patients, staff members and the service. Like the RAF flight planners in an old black & white film!
Each carer I speak to has a small ‘off-load’. I know carers find it helpful to speak to someone who treats them as a person and not just a carer, and someone who really listens.
Support for carers
Carers can easily get stressed and exhausted and then can’t continue to support their loved one. A carer’s world can become very silent and isolated as their loved one may not be able to communicate or even have a conversation. We are there for them emotionally and physically.
We have a request from a district nurse supporting a gentleman at home who has dementia. His wife is exhausted and in need of some respite.
We make contact with her and offer a visit to enable her to have some time out of their house. She reports after the visit she took the opportunity to have her hair done which made her feel, in her words, 'a million dollars'. We have a conversation about the limit of our service. We can provide a small number of respite visits, whilst a longer term solution is found.
Helping patients to share memories with loved ones
A Wellbeing at Home HCAs drops into the hospice to collect items she will be giving to a family on her next visit. The lady has shared she would like to put a memory box together for her family. We have some ideas to share with her to help her to create this.
At the end of the day, I make a referral to the Benefits Advice Service to help a family ensure they have the financial support they need.
Wednesday
I take a phone call from a daughter who is angry and upset about what’s happening to her dad. She feels everything is very unfair. I listen. She shares with me that she found it easy to talk to me.
Over a cup of tea, we have a discussion with the Treetops Occupational Therapists about a Wellbeing at Home patient. They have no equipment around the home and would benefit from an assessment. Our Occupational Therapist agrees to liaise with the family and refer to the community therapy team.
Thursday
We receive chocolates and thank you cards when a family call into the Wellbeing Café to say hello. I have spoken to and emailed this family regularly. Dad died and they came in to say thank you.
Their visit is made more poignant because I have spoken to this family at their most frightened and vulnerable, but never seen them face to face.
I’m asked to go into the Wellbeing Café to speak to a gentleman and his wife. She has a life-limiting condition, and he is unable to leave her on her own. I contact their GP surgery to discuss their needs. They agree additional support is needed and we arrange our assessment.
We continue to get several referrals in the afternoon from District Nurses.
Friday
I refer a patient who’s approaching end of life to our Hospice at Home team as his family are asking for extra support at night.
Liaison with other local services
It's a busy day on the phone. A family member gets in touch asking us if we can visit a patient and help get them washed and dressed every morning. I explain that we are not a care service, and signpost them to their care co-ordinator to explore options for support.
I’m asked to speak to a member of the Tears to Laughter bereavement support group. She has an elderly relative with a life-limiting condition and feels they would benefit from the Wellbeing at Home support and our Befriending Support.
We end the week with all visits finished and everyone looking forward to the weekend.