Rebecca Meyrick, who is head of outreach services for the North Norfolk hospice Tapping House, gave a talk at the AGM of churches together on Wednesday 1st October 2014 at the London Rd, Methodist Church. The talk was entitled: ‘Dying to be Loved: Better Together in West Norfolk’.
These are exciting times for Tapping House hospice because staff moved into the new building at Hillington 2 weeks ago. Rebecca became head of outreach services for Tapping House 2-3 years ago after the Clinical Commissioning group, which buys services on behalf of the GPs and public, set up home palliative care services locally. Tapping House is now entering a time of transition from the day care service of the past 30 years to become part of a palliative care service which is delivered with many organisations. Rebecca’s talk covered the following topics:
- The national and local palliative care scene.
- West Norfolk.
- Caring for the dying – including the current prevalence of death denial.
- The Christian response to death.
- How the church and community can help.
The hospice movement started 50 years ago in response to a desperate need for the dying to be cared for and given adequate pain relief. Today the hospice is not somewhere you go when you are dying but rather a place for 7-10 days of care to control symptoms after which the person returns home to be looked after. Care is now provided by a wide variety of groups which include the Norfolk Hospice Tapping House day therapies at the new building in Hillington; the Macmillan Day Care Centre at the hospital; the hospice at home service which includes Marie Cure nurses and carers; the CAST team (community care and advice team); Norfolk community health, the Queen Elizabeth Hospital; the Marie Curie discharge liaison nurse who organises urgent discharge to home for terminally ill patients who wish to die at home; community nurses; GPs; consultants; the community referral hub; Amberley Hall which is a nursing home with beds for terminally ill patients; the Macmillan nurses and the palliative care hub. These services are due to face more challenges in the future because the numbers of elderly people will increase. Norfolk is currently the county with the oldest population in the UK. By 2024 there will be 30% more men and 20% more women dying of cancer. With time the NHS budget will become tighter and poverty will increase. All these challenges mean that those who plan and work in palliative care services will need to up their game.
In response to these challenges a national group called ‘Help for Hospices’ was set up in October 2011. This group looked at the evidence and after a public consultation they published a report in January 2013. Only 5% of terminally ill people are being cared for by hospices although most of the public who were questioned said that they wanted to be care for by a hospice. The report showed that there is confusion over access to hospice care and other staff in the NHS saw hospices as inflexible and disconnected.
New ways of thinking and working are required. More care for people in their own homes has locally produced, in the first year of the hospice at home service, between 100 and 150 people being cared for at home. There is more education and training for NHS staff in hospitals, GP surgeries and care homes. One Macmillan project educates children in schools about palliative care. There is more co-operation between groups and charities. The Marie Curie charity will fund the nurses at Hillington so that beds can be opened but these beds have yet to be commissioned by the NHS. The service at Hillington will be merged with the Macmillan nursing service. It is important that the whole community has access to the service including the mentally ill and vulnerable members of society who may not have the ability to help themselves with the service access.
A hospice is not just a building but a facility to help the sick to live well. The sick person will have emotional, spiritual, and social needs as well as physical needs to be addressed. The patient’s relatives and carers also have these needs and require support. This support helps the people involved to deal with suffering, illness and uncertainty through education and role modelling. Emotional support can be provided by encouraging the person to record their life story, to create a memory box or undertake reminiscence therapy. Practical social support may also be required and this may include advice about housing, benefits or the application for a care package. Revd Sue Martin from the hospital chaplaincy is also the hospice chaplain and provides spiritual and psychological support. Other support facilities which are available at the hospice include physiotherapy, complementary therapies, gardening, art, mindfulness and relaxation classes, stress and uncertainty management classes, bereavement support, counselling, telephone contact, coffee mornings, one to one discussions, a walking group and memorial services. As part of the family support service the team can help patients and relatives to talk to the children in the family.
For terminal care at home patients are referred when it is estimated that they have about 6-8 weeks to live. A comprehensive assessment of the person’s needs is undertaken and this includes an assessment of the available family and carer support. One aim is to prevent inappropriate hospital admissions. There may be a lot of time and patience needed to build up a rapport with family members who may sometimes feel that dying is a private event. The team need to be sensitive to the privacy of the family and to give them space. A good death means one which is consistent with the values of the person who is dying. There may be denial and collusion among family members who often have little experience of the death of a close family member and they can benefit when they come to see dying as a unique life experience. In the Christian tradition, caring for the dying person is caring for Christ. This means that the vulnerable and weak person should be shown justice and compassion in a way which is personal to them.
How can people help the hospice project? You could come to see the building to get enthusiastic and involved. Churches together will be organising a visit. You could help with fund raising. 8 in-patient beds are planned but 16 are possible with the current building design. There are various jobs for volunteers and Tapping House has a long history of involvement of volunteers.