Types of care
Palliative care
Palliative care is the medical care given when a person is experiencing distressing symptoms from an illness which is no longer curable. This care aims to keep symptoms to a minimum and prolong independence and mobility for as long as possible. Palliative care can be given whilst a person is at home. This might involve frequent visits to the GP, hospital specialist or palliative care specialist for changes in medication and review. It might involve treatment review by specialist nurses in the home or at a clinic. Frequent contact with services is the norm, as symptoms and their method of control may change regularly in the final few months. Level of disability and care needed is also kept under constant review in order to provide additional services when required.
Very little professional care may be given or recorded beyond these review visits. Often family members will be carrying out significant care tasks without necessarily recognising they have become ‘carers’. This sort of care will often include transporting their relative to appointments, shopping, cooking and cleaning and help with personal care as disability increases. This may include ensuring medication is taken; food is eaten and help with washing, toileting, dressing, shaving and mobilising around the home. Where relatives are unable to provide this care, home care teams may be used or admission to a nursing home or hospice arranged.
Respite care
Respite care is the term used to describe short breaks in hospital or a hospice to give family members who are also carers a break from caring for the person with cancer. This can be to allow them to undertake other activities, to receive medical care themselves or have a break. The provision of respite care can enable families to keep their relatives at home for longer periods. Respite care may also be used to monitor symptom control and get troubling symptoms under control which have been difficult to evaluate or manage in the out-patient setting.
Hospice care
The hospice movement was founded by Dame Cicely Saunders to provide end of life care for people with cancer. As the movement has grown the role of Hospice care has expanded to include:
- Care of people with cancer before they become terminally ill.
- Respite care.
- Care of people with non cancer progressive terminal diseases e.g. Motor Neurone Disease.
- An expanded role in providing support for relatives of the dying and bereaved.
- Day centres.
Hospice care deals with the physical aspects of living with cancer including control of symptoms, and the emotional and spiritual needs of the person with cancer and their family. Hospices are usually housed in separate buildings away from the acute hospital setting (they may be on the same or another site). They are often charitable trusts and have a separate management board even when they are located next to the hospital. The Hospice may co-ordinate or provide significant amounts of outreach care to enable the person with cancer to live and die at home. Some people may not be able to access these specialist services.
