Hospices aim to meet people’s physical, emotional, social and spiritual needs. The range of services includes pain control, symptom relief, skilled nursing care, counselling, complementary therapies, spiritual care, art, music, physiotherapy, beauty treatments and bereavement support. All this care is free of charge, often supported by a charity.
Several people with cancer felt that they were relatively lucky to have access to such resources, which are rarely provided for people with other serious illnesses. (Those with motor neurone disease, HIV and AIDs can often get hospice care, but not always).
Many people we talked to attended a hospice day centre for one or more days a week, sometimes over many weeks. Usually, a hospice has written criteria for admission. This policy identifies those patients for whom the service is provided. The patient’s and family’s needs are usually assessed before admission to day care (see also ‘Insufficient hopice care‘).
A man with secondary progressive multiple sclerosis said that demand for places at his centre was heavy, but said that he might be able to increase from one to two or three days if he needed to. Some people spent time as in-patients too (see ‘Hospice in-patient care’).
Nearly everyone said that at first they were very apprehensive about attending a hospice, but had been very pleasantly surprised by the happy atmosphere and the wonderful support they received. Several said that the public image of hospices needs to change -they are definitely not dreary and gloomy places with people sitting about waiting to die. Rather, they are described as creative havens where people go to enjoy living and get to know others in an accepting and supportive environment.
Many of those who work in these settings have a firm religious faith and some have chapels or provide religious services for those who want to attend. However, this was not compulsory and staff do not push their religion on people who are not interested.
Some of the nurses at the hospice are quite religious but do not push it on those who do not want…
A 51-year-old woman with breast cancer managed to find a hospice which had a special day for younger people. She found sympathy, support and medical help. She also tried various complementary therapies, such as art therapy, which helped her cope with the shock of the diagnosis. She enjoyed her days at the hospice, but found it hard watching others deteriorate and ‘pass on’. Another woman had been less fortunate – she found herself in the company of much older people, which she didn’t like. Some of the other patients wanted to ‘offload’ their problems onto her, making it even harder for her to cope.
She found the staff very supportive and enjoyed the activities but found it hard watching others…
She would prefer to go to a day centre with others the same age as herself.
A man with colorectal cancer advised other people to attend a day centre because he was sure that a day out could help people to forget their troubles. He had always found something to do, such as gardening, or a ‘bit of joinery’.
He enjoys going to the hospice – there are always things to do such as gardening or joinery.
Another man said that if he wanted he could have a bath or a jacuzzi at the day centre, but he preferred to chat to the friends he had made since he had been there. He remarked that friendships can grow very quickly in this environment.
One woman had benefited from creative writing and poetry, which the staff at her hospice taught and encouraged. She also spoke about the love and laughter she encountered each time she attended.
To her the hospice is a happy, loving place where she has learnt to write poetry.
Another woman pointed out that when she visited her hospice she could have reflexology, try various crafts, have her nails done and hair ‘titivated’, have a drink, or simply sit and sleep. She also felt that the staff and the other patients had helped her to come to terms with her own impending death.
She can have her hair done while at the hospice or have reflexology or do crafts, or simply sit…
Staff and patients have helped her to come to terms with illness and with death.
Day centres do not appeal to everyone. Some were aware of people who had visited to look around and never came back. One woman said that she was not a ‘day-centre person’ because she did not want to do basketwork or painting and that she had plenty to do at home when she was well enough to look after herself. She also said that she didn’t want to chat to others or know about other people’s illnesses.
Although everyone who attends a hospice day centre has a serious illness, several people said that they tend to talk about other ‘lighter’ matters – perhaps being sensitive to others who are more unwell. However, this sensitivity, combined with being kept busy, could sometimes deter those who wanted to talk to other patients about how they felt.