Hospice in-patient care

Hospices aim to meet people’s physical, emotional, social and spiritual needs. Some people need particular help in controlling pain or other symptoms, and may be admitted for a short while if a bed is available (see ‘Insufficient hospice care‘). Many of those admitted return home after a few days, when symptoms have been controlled.

A few hospices offer respite care to those who are seriously ill, though this is increasingly rare. Many offer day care support to those who can stay at home (see ‘Hospice day care’), and some offer short-term intensive home support (see ‘Care at home: nursing’).

Hospices strive to offer dignity, peace and calm at the end of life. People who are dying may be able to remain in a hospice, receiving expert care from doctors, nurses, social workers, counsellors, physiotherapists, and other members of the team, until they die.

A few of those we talked to had spent some time in a hospice as an in-patient. One woman, for example, went into a hospice for respite care for two weeks every three months.

Some people compared care in a hospice with care in a hospital, and said that hospice care was more relaxed. For example, one man said he could get up if he felt well enough or he could stay in bed as he wished. He wasn’t ‘forced’ out of bed. People also mentioned that in their experience hospices (which are usually funded by charities) were better staffed than hospitals, which meant that nurses had much more time to sit and talk and attend to all their other needs.

Says a hospice is more relaxed than a hospital and he is never forced out of bed.

Age at interview 58

Gender Male

Age at diagnosis 56

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I mean, I’m never forced out of bed. If I’m feeling a bit sort of tired, I’m never forced out of bed or anything like that you know;

And that’s another thing with the Marie Curie, when… In the Marie Curie it’s not like a hospital, it’s more of a ‘oh just do what you want to do’, you know you’re just going to be… sort of just get up at 12 o’clock, have a wash, because obviously theres a lot of ill people in these places who haven’t got long to go like, but the general atmosphere is just one of a very relaxed sort of nursing, yeah. Great.

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The nurses always had plenty of time to talk to her.

Age at interview 61

Gender Female

Age at diagnosis 41

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Yes. I honestly think that neurology centre was very good, is good. I think the nurses are good but the hospice is quite a different experience altogether because they are much more laid back and they’ve always got time for you. Any time. As much time as you like. Just talking and I like that. And there is one particular girl on nights and she did six nights when I was there and I really got to know her. She stated that she was going to do this, that and the other. She just explained to me what she thought she would do and if I didn’t want to do anything I didn’t have to do it.

That sounds really good.

Yes, it’s very good.

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Some people imagined that a hospice would be a depressing place. One woman who we talked to found it very upsetting to realise that other people had died during her stay.

Having seen others die she hopes that when she nears death she will be able to end her life with…

Age at interview 61

Gender Female

Age at diagnosis 59

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I spent a month in the hospice before you know and after having this shunt fitted and in that month just unfortunately probably nine different ladies came into the ward and died. I watched them. I saw them come in on day one they’d be fine, chatting and by about day four or five they’d gone. So I have seen what happens at the end and if I could avoid it happening to me I would, simple as that. I know what I’ve got to look forward to;

It’s was bad luck really in a way for me that I spent that month in the hospice really bad luck because I’ve seen it first hand where as in the past I could only guess at I suppose what it could be like at the end and its not a pleasant prospect and if I could just take enough of something to put myself to sleep for good. I would happily do it and… If somebody wants, you know wanted to help me… if somebody was brave enough to help me I’d be grateful to them.

Well some countries are introducing, it as a policy, aren’t they? So it is being..

Yes I know but I haven’t read anything about it. I mean I’ve seen the headlines from time to time somebody went to the European court didn’t they for the right to die? I can’t remember what the outcome was now;

But it’s a way of people having control isn’t it?

Yes, I was gonna say it’s almost a nonsense if we can’t decide what to do with our life at the end isn’t it; Why should a judge be able to say no I can’t kill myself if I want to?

When you said it was bad luck to be in the hospice then, do you mean because there were that number of people who were coming to the end of their lives?

I think so, the nursing staff kept saying to me, ‘It’s just unfortunate that you’re here at this time. It just happened to be a bad time for them apparently, but it wasn’t pleasant. It wasn’t a pleasant experience for me.

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Others were pleasantly surprised. A man who had at first said he wanted to die at home had changed his mind after getting to know the hospice.

Many talked about the peaceful environment. A woman with lung cancer described the calm atmosphere and the excellent care she received. Food was prepared exactly as she wanted it, and pre-dinner drinks were available. She was offered complementary therapies, including music therapy, which she found helpful.

The care she received in the hospice was ‘amazing and she would happily return there.

Age at interview 63

Gender Female

Age at diagnosis 56

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I didn’t know how long I was going to stay and because I was feeling really poorly I just felt ‘I don’t care what people do with me. I just wanted to lie down quiet in a darkened room.

My brother, sorry, my son took me, and it sounds strange but we both said this, as you walk in, it is a beautiful place but as you walked in you felt a blanket come over you of calmness and care. And the staff were just amazing, absolutely amazing. They really did care. Genuinely care and pandered to my every whim. Whatever I wanted I could have. They were always there for me, they remembered everything. And the first day I heard the trolley coming along the corridor – clonk, clonk, clonk – and I thought oh it’s the time for medicine, but it wasn’t, it was the drinks trolley for the pre-dinner drinks.

Oh yes.

Which sort of sums it up. Meal times they always asked you, they didn’t give you a menu, they asked you what you would like and I like toast in the morning and it came up fresh, still with the butter melting. You know there was that much care.

The little things, yes. And they would sit and talk to you and I know I had a room on my own but I didn’t see anybody die.
I wasn’t aware of anyone dying because that would have absolutely terrified me. And if… When I have to go back again I’d be quite, quite happy to do so. In fact some days when I’m really poorly and I sit here and I think ‘oh it would be nice to be in the hospice and be looked after’, but then no, I’m not giving in to it.

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Describes the hospice, its facilities, the various complementary therapies, and peaceful…

Age at interview 63

Gender Female

Age at diagnosis 56

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And there is another thing, I’ve totally forgotten. They have a music room in the hospice with every conceivable instrument and they asked me if I would like to meet the musician and have a session with him, and I said, ‘Well I’m not musical-minded. I cannot read music. I don’t play the trumpet, the violin, the piano, anything. And they said, ‘No, that’s not the point of it,’ and I agreed. And this very charming gentleman took me in to this room and sat me in front of the drums and just said, ‘Just do what you want.

And I could see where he was coming from, to get that, feelings out, banging on the drums and also he had me at the piano and of course I didn’t know what to do but I did find that, oh it sounds all rather silly doesn’t it, but that was interesting, that was intriguing that they felt that music would help.

Oh, I’m glad you remembered that.

Yes, if you physically play the instruments…

Is there a chapel at the hospice?

No, no.

If you wanted to get out to church could they take you?

Oh yes, yes and you could also go out.

Hmm.

You see one day my son came over with the children and there is a play room there fully fitted with toys, even a computer for them to play on. But it was a lovely day so they took me out for lunch and then brought me back and that was very nice.

It sounds like a wonderful place.

Oh it is, it is. Yes, yes. So what have they got? They’ve got the hairdressers, the music room, the aromatherapy room, a room for friends and family to stay overnight if need be. A day room where you can meet and you know have a coffee and do whatever. A dining room if you want to go and have your meals in the dining room and as I said beautiful rooms with en-suite facilities. And this wonderful feeling of peace.

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A man with prostate cancer had two spells in a hospice. He was impressed by the efficient organisation, and the way in which his pain was controlled (see also ‘Pain and pain control’).

He was impressed by the organisation and with the way the doctors at the hospice managed to…

Age at interview 66

Gender Male

Age at diagnosis 63

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I went to the hospice a couple of times. The first time it was to check the reasons for pain and identify the best means of attacking it. During these tests it was noticed that I was anaemic. And the second time I went into the hospice was for a blood transfusion. They gave me quite a lot of blood, and that is why I was there for a number of days. Those were the reasons for the hospice visits.

What was it like there, as a patient?

It was very nice. The people were very kind, and I was absolutely amazed at the organisation. The number of staff, number of patients, all had different, different ailments, and everything worked like clockwork. I was very impressed. I wish we could have some of that in industry.

And how did they manage to sort the pain out?

By choosing correct medication, whereas elsewhere the GPs were struggling with different medications. I found the consultants in the hospice were able to tell me straight off what was the matter and the first medication they offered worked. It happened twice. That’s why I was very impressed.

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The staff do their best to help patients and their families. One woman mentioned that there was a playroom for visiting children. Another person said that his local hospice had a special room for people wishing to smoke.

Rooms are sometimes available for relatives who wish to spend the night. One woman was allowed to stay in the hospice when her husband was dying. She was given a bed beside him in a private room and was there the night he died.

When her husband was dying she was given a bed in the same room so she could be with him when he…

Age at interview 67

Gender Female

Age at diagnosis 57

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And they were so considerate. They put him into a room on his [own] because they felt that he was a rather private person and they were absolutely right.

Indeed I don’t know if you want to know this but they did ask me to stay because the roads as they put it were so slippery. Well of course they weren’t. I could’ve gone down the main road and I’d have been perfectly alright but it did mean that in fact he and I… they brought in another bed into his bedroom and they dropped the cot side between us and we went to bed as we always had done on his last night.

Oh, that must’ve been wonderful.

It was. If you’d had a million pounds, with the care that we… that they… that we had on hand, the slightest ring on the bell, someone was there. I didn’t have the responsibility of caring for him but I had… he had the comfort of my being with him;
Indeed he had said, “I’m so glad you’re with me tonight, I didn’t want to die alone.

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For more information and help finding a hospice see our Resources section.

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