Health and Social Care Professionals
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Live-in Palliative Care helps Patients and Carers alike
Since 1962 Consultus has helped thousands of people to achieve their wish of dying contentedly in their own home. Today, our live-in nurses and carers are with many private and continuing care-funded clients providing 24/7 nursing and family support.
As our PCT and Health Board clients already know it is possible for a terminally ill patient to be nursed appropriately and within budget at home by a Consultus live-in nurse.
A Consultus Live-in Nursing Service (CLINS) manager will help you to identify whether our service is appropriate for an individual patient. Staff work closely with local district nurses and care providers, usually receiving a formal handover from the hospice or hospital on the day of discharge.
Researched benefits of home nursing for palliative patients
The following widely-held beliefs are supported by key research:
- Issues that determine a 'good death' include location, environment, presence of others, physical comfort and burden on family (Tong et al, 2003)
- Patients report similar or better pain and symptom control and better physical quality of life when cared for at home, compared to conventional care (Hearn & Higginson, 1998; Higginson et al, 2003; Smeenk et al, 1998, Mercadante et al 2000).
- Hospital re-admission rates can be lowered among patients cared for well at home (Smeenk et al, 1998).
- Reported carer satisfaction tends to be higher with home care or care provided in the community as compared to hospital care (Higginson et al, 2003; Smeenk et al, 1998; Wilkinson, Salisbury, Bosanquet et al, 1999).
- Analysis concludes that extending high quality palliative care in the community would, if achieved appropriately, open the way to both NHS savings (or other service improvements) and a better quality of life for individuals and families facing death" (Valuing Choice – Dying at Home, Marie Curie Cancer Care).
We know that some commissioners are concerned that crises may arise for patients and carers that they cannot cope with at home, or that carers may suffer additional stress in the last few days of the dying person's life. Some believe that for these reasons home nursing should either be discouraged or lead to late stage hospital admission. However, establishing a live-in nurse in the home negates these arguments because many medical problems can be forestalled or eased by the nurse, and the family is relieved of much physical strain and anxiety.
A qualitative study (Koop & Strang, 2003) draws attention to psychological benefits linked to home managed deaths. Bereaved carers spoke of a sense of having accomplished something difficult and very valuable, of having done the best they could and providing what they believed to be the best possible care.
Some carers felt that end-of-life care-giving at home had strengthened their relationship with their friend or family member. Others said that witnessing their family member experiencing pain and discomfort close at hand was in fact a positive experience as it allowed them to feel relief and gratitude when death finally occurred.
Meanwhile, Thomas (et al, 2003) found that some carers of end-of-life patients reported significant adverse effects from the decision to admit their loved one to hospital. Feelings included regret and guilt that their family member did not die at home.
A Marie Curie report says "There is robust evidence that most people would ideally prefer to die at home, well cared for and in their own familiar environment ". (The report also contains excellent research on "Where and how people want to die" and "The costs of dying at home ", including tables of costs in relation to hospital and home care in the last weeks of life. We recommend that you compare NHS cost tariffs with our rates for live-in nursing, available on request).
Marie Curie concludes that "Enhanced public funding should be given to independent organisations which supply high quality home palliative and supportive care."
Find out more
Please contact Consultus Nursing for more information about live-in palliative care or click the next link to see how we help authorities with Continuing Care packages.
"Thank you once again for all your care of E. It was lovely that he was able to die in his own home, surrounded by those who loved him best. That certainly wouldn't have happened without you."
E & J, Dorset
"It was my great desire that he should be allowed to die at home and the nurses you provided, along with the District Nurses, made this possible…Such great care and devotion."
PK, Norfolk
"Cancer and other [palliative] patients have consistently reported a preference for dying at home"
Higginson & Sen Gupta, 2000
"Extending palliative services for people wishing to die at home…should both save the health service money and enhance the well-being of both the dying and their carers. Recently the DoH has committed itself to extending choice in this area."
Valuing Choice – Dying at Home, Marie Curie Cancer Care, 2004
