A hospice offers expert palliative care from a team of professionals – doctors, nurses and social workers, among others. They work with GPs and hospital staff. The hospice staff are experienced not only in symptom control, but also in giving emotional support to patients and their families.
People sometimes think that you only go to a hospice to die. Some people do go there to die, but many others go for a short stay, and then return home once their symptoms are under control.
Hospices can also admit someone for a short time so that his/her carer can have a break. The person themselves may need a break from home and family too – and most hospices offer day care for this purpose and some may offer activities such as art therapy on a regular or short-term basis.
Hospices usually have nurses who do home visits. They can advise you about symptom control and about how best to look after your relative. People are usually referred to a hospice by a hospital doctor or a GP. Most hospices also offer bereavement support for the relatives of a patient who has died.
Non-cancer patients and hospice care
It is NHS policy that everyone with a life-threatening illness should have access to the appropriate palliative care services. Yet for many reasons, mainly historical, most people admitted as hospice in-patients in the UK have had a diagnosis of cancer.
In the past hospice funding has come from cancer charities, and less is known about the palliative care needs of non-cancer patients and less is also known about how long people with other life threatening illnesses are likely to live.
Depending on what illness you have you could try contacting the relevant charity or support group and ask them for advice about getting hospice care.
It is always a good idea to talk to your GP/your hospital consultant and also your local hospice and tell them what you think you need.
Is hospice care available free to everyone whatever their financial circumstances?
Yes, hospice care is free of charge to patients and their families. Most of the hospice care in the UK is provided in units run by charities such as Macmillan; the NHS contributes about 30% of their funding and running costs.
Can you ask your GP to arrange for you to have hospice care?
Yes you can ask, and most people with a terminal illness will be referred for hospice care by their own GP or other member of the primary care team.
Your healthcare team will try to weigh up a number of things in your case: for example, whether you have become physically incapacitated and would benefit from receiving advice and treatment (including regular monitoring of symptom control) in a hospice setting; whether you would benefit emotionally from the kind of group support and companionship that hospices can offer; whether you would find it helpful to have counselling and other kinds of therapies that may be available in your local hospice.
Your primary care team may well also consider whether your family circumstances would allow you to continue to be supported and cared for at home.
Who decides how much hospice care you can receive?
Ideally the decision should be jointly made by you and the hospice staff. In practice though it is often members of the hospice staff who decide how much care you receive, though they will do their best to meet your needs. Inevitably the amount of care you are offered through your local hospice will depend on what is available at that particular time and also what kind of services they offer. Some offer day-care, some offer particular activities (e.g. music and art therapy, relaxation classes) at particular times. Hospices do not all have the same resources or expertise.
What health conditions do hospices cater for?
Some hospices/palliative care units may have a written policy about what kind of care services they provide and also outline the types of illness they can work with. Day-care units are usually open 6 days a week but their services are mainly for adult cancer patients though others with progressive life-limiting diseases such as motor neurone disease or HIV/AIDs may be catered for. Other groups of patients, for instance those with advanced heart failure or progressive neurological diseases may find that they cannot be considered for hospice care, but this issue is beginning to be addressed.