Palliative care (Wisdom Hospice)

We understand that being admitted to the hospice may be a difficult decision for patients and their families, whereas others find it a relief that the nurses, Doctors and other staff are able to care for their loved one so the family can concentrate on just being their spouse, parent, sibling, friend. 

You may decide to be admitted for symptom management control, or for your end of life care. However, we are a short stay unit (approximately 2 weeks) and if your condition stabilises we will discuss with you and your family about transferring you to a more appropriate place for ongoing care, which could be your home if you wish with carers/nursing support or to a care home.

The ward is divided into three single sex bays with four beds in each bay and three individual side-rooms with en-suite facilities. Patients may occasionally be required to transfer from one bay to another or to vacate a side-room, in order to assist ward staff in maintaining strict single sex accommodation. 

Staying in contact with your loved one 

We respectfully ask that only the next of kin telephones the ward for updates on patient’s condition and they pass information to other family members and friends to avoid frequent and repeated telephone calls to staff. Ward staff can transfer calls to the patient’s bedside, please note these phones do not allow outgoing calls. 

Please be aware that staff may be busy with patients and unable to answer the telephone immediately. Our telephone number is 01634 830456. 

Staff are able to support patients with telephone or zoom calls to stay in touch. Please discuss with a member of staff. 

Spiritual care 

Nursing staff are able to contact faith leaders at any time. Please ask a member of the nursing staff if you would like a visit. 

Infection control 

Visitors who are feeling unwell are respectfully asked to avoid visiting patients, and should not visit following diarrhoea and vomiting until free of symptoms for at least 48 hours. 

Covid – if you have any symptoms please do not attend. 

Property 

You are advised to bring as little as possible in with you, two changes of night clothes, slippers and toiletries with some clothes if you are coming for symptom control if you think you may feel well enough to get dressed. We do have a supply of nightwear and toiletries if needed. 

We strongly advise you do not bring items of sentimental or high financial value as MCH does not take responsibility for any items bought into the hospice by patients. If you decide to bring in such items e.g. mobile phones, jewellery and wish to keep them with you, you will be asked to sign a disclaimer. 

We are able to store a few small items for you in our safe if you so wish. Patients, or their next of kin, will be asked to sign that they are happy to hand these over. 

If you bring in additional items, please inform a member of staff. 

We are a team who offer patients, families and carers help in supporting their loved one to remain at home with their symptoms controlled by the use of medication or alternative therapy.

We will provide advice on medication, symptom management, and what to expect as your clinical condition changes or as you approach the end of your life. We will liaise with your GP, Oncologist or other healthcare professionals in order to support your changing needs and help maintain an acceptable quality of life. Your GP will remain your primary carer and community nurses will provide clinical aspects of your care, such as injectable medication when needed. Our support will be in addition to theirs. 

Our support is by clinic appointments, telephone and visits to the home. A member of the CPCT will refer you to other members of the multi-disciplinary team if needed, for example, Doctors, OT, physio or listening support. 

The CPCT does not provide personal care but can facilitate a referral for a package of care if assistance is needed for washing, dressing, toileting or prompting for medication. 

Molly’s Hub offers patients and families holistic hospice care – in addition to their medical treatment such as: 

Seated exercise

People with limited mobility or physical fitness can enjoy a fun fitness class that will still make you ‘feel the burn’! 

On the health side, participants will aim to increase strength, flexibility, mobility, improve posture, stamina, co-ordination, balance, and overall fitness.

Plus, they can do them at home too, once they know how. 

Circuit group 

This group is for people with a little more mobility, and is an 8-week course, aimed at teaching participants how to do the exercises at home or in a gym. Measurements will be taken at the start and end of the course, so that progress can be seen – which often helps with motivation. 

Gym equipment includes gym balls, rebounders, parallel bars, resistance bands, weights, a treadmill and hand bike. Bodyweight exercises are also part of the programme.

Guests will be welcomed into the hospice gym – to gain confidence on equipment. 

Living Well 

This 12-week rolling programme will include physiotherapy sessions, guest therapists giving guidance on various areas of wellbeing, self-care, eating and drinking support, plus of course, the social side meeting other people. 

The programme aims to offer new experiences, improve quality of life and mood, whilst offering the chance to build peer support. 

Arts and crafts 

This creative group will give patients and families the opportunity and space to develop new skills creating artworks and objects, such as hand moulds, that reflect their unique experience and interest that can be given as a lasting memory to a loved one. 

The group will be suitable for artists of all abilities, including complete beginners. Our team and volunteers will help develop ideas – come to be creative! 

Carers’ drop-in/café 

This informal drop-in support group will offer an opportunity for carers to meet with others who are caring for a relative/friend/loved one with a life-limiting condition. 

They’ll be able to meet others to share experiences, swap knowledge of support available and develop friendships and informal peer support. 

Breathlessness goup 

The three-session course will help people to maximise their breath, making daily tasks that little bit more manageable; mobility, eating, drinking and sleeping. 

Fatigue group 

This group will help people to gain tips on how to conserve their energy and reduce the onset of daily fatigue. The group will enjoy slowing down with Tai Chi, chair yoga, and tips on energy conservation, such as sitting to get dressed or using an electric toothbrush – tailored to your lifestyle. 

The group will be small and guests will learn tips and advice to take home.  

Complimentary therapy 

Massage, Reiki and Acupuncture will be on offer, totally free of charge, to patients who would benefit from these lovely therapies. The sessions give them the chance to try a holistic therapy – to help with a symptom, side effect or impact of their condition. 

Memory matters 

This group is for both patients and those close to them, to make memories together. Activities will include memory boxes – making a lovely box and special things to go in it, hand casting, fingerprints, making music, and taking photos. Activities will be based around what a family needs and asks for – with everything being offered where possible. 

Find out more 

If you’d like to find out about taking part in any of our groups, just get in touch with a member of the therapy team on 01634 830456. 

Referral  

The palliative care referral form needs to be completed by a Healthcare Practitioner (HCP). There is wellbeing pathway option on the form. 

We are a small team of palliative care nurses and palliative clinical nurse specialists. We have additional support from Advanced Clinical Practitioners (ACPs) and Palliative Consultants, though they are based primarily at the Wisdom Hospice. 

We provide specialist palliative advice and support for patients with palliative/terminal diagnoses. We provide advice, support and management for specialist symptoms that may occur as a direct result of these diagnoses. However, the patient’s primary doctors and treating teams should be pro-active in reviewing, monitoring and aiding symptom control where they feel able to, in the first instance. 

You may be referred to our CPCT when you leave the hospital, if it is appropriate. Most of our patients need ongoing support on leaving hospital, and this is available from the Wisdom Hospice. With your consent, we can inform them to make contact with you after discharge. The team work closely with your GP and community nurse to care for you at home. We will also provide them with information about your recent hospital stay. 

What is the medication clinic?

The Medication Clinic is available to treat patients in the community who are not house-bound but are able to leave their homes and attend a short appointment to meet their medication needs.

Some patients may require medication which needs to be given via subcutaneous or intramuscular route. Some patients would also require intravenous medication, these patients would have an intravenous line inserted into their veins to treat a variety of conditions such as infections or chemotherapy. Sometimes patients do not need to be in hospital in order to receive this type of treatment. The Hospital Team, your GP, MedOCC Service or the Community Nurse will refer you to the clinic and provide you with the information to make appointments.

Referrals

Please email medch.medicationclinic@nhs.net, if you wish to refer to this service (we are working to have an online form as soon as possible).(opens in new tab).

For non-mobile patients please refer to the Community Nursing Team.

Exclusion criteria:

• Medications that requires more than twice a day administration
• Medications that require daily blood monitoring
• Non- intravenous antibiotics infusion
• IV fluids
• Blood transfusion
• IV medications other than IV antibiotics
• Iron transfusion.

Your appointments

Please bring with you any documentation you received on discharge from the hospital or clinic that initiated your treatment.

Bring the medication that needs to be administered and any paperwork provided with the medication. Be aware that the appointment time can depend on the time your last medication was administered.

In the Medication Clinic, you will be seen by a Nurse trained to meet the standards required in order to administer your medication. You may be in the clinic for 15 minutes or up to one hour dependent on your treatment, this will be made clear to you prior to your appointment.

You may be able to have someone with you dependent on latest operating guidelines. This will be explained prior to the appointment.

Every effort will be made to ensure that we keep to time, but occasionally, there may be delays, we will do our best to keep you updated if any delay occur.

Future appointments (if required) will be booked before you leave.

If you need to change or cancel your appointment, please call 0300 123 3444 to re-arrange your appointment as this may be vital to your treatment

Blood tests

Some treatments require a blood test to be carried out alongside it. This can also be done whilst at the medication clinic and does not need a separate appointment.

Please make sure that you bring along blood test forms that your clinician provides you.

Parking

Parking is available at the clinic venue.

Living and coping with a serious illness can affect people in different ways. There may be times when you feel hopeful and are managing well. There may also be times when you feel uncertain, frightened, angry, sad or distressed. Some people feel alone, confused, hopeless or overwhelmed. Relationships, intimacy, confidence and a sense of purpose can also be affected. These feelings and changes are natural responses to what patients and those close to them may experience. Everyone's experience is different.

What are anticipatory medicines?

These are a small supply of medications for you to keep at home just in case you need them. A doctor or healthcare professional who is a qualified non-medical prescriber will prescribe anticipatory medicines that can be given by injection, which may include the following:

• Morphine
• Levomepromazine
• Glycopyrronium bromide
• Midazolam.

You cannot take these medicines yourself; they can only be administered by a doctor or nurse. The medicines will come with a medication dosage advice sheet/generic which authorises your District Nurse to give you the medicines if you need them.

What are the risks of these medicines?

All medications can have side effects. The possible side effects of the
anticipatory medicines will vary depending on your condition and other
medications you may be taking at the time, but may include drowsiness,
nausea and dry mouth. Your doctor or nurse will discuss possible side
effects of the medicines with you and those caring for you if you should
need to use them.

Are there any alternatives to these medicines?

If you are able to take tablets or liquid medicines you may be offered the medicines in these forms instead of having them as injections.

Palliative care is the active, holistic care of people with advanced, progressive illness.

Physiotherapy can play an important role in palliative care. It aims to help people maintain their quality of life and stay as independent as possible, regardless of their prognosis.

Physiotherapists provide rehabilitation to help people with a palliative diagnosis continue to function with as little dependence on others as possible.

Physiotherapists can help with several areas, including mobility, breathlessness, pain, exercise and fatigue.

Mobility

The physiotherapy team can assess your mobility and provide appropriate walking aids.

They can also prescribe exercises to help if walking is becoming more difficult.

Breathlessness

Breathlessness can be a distressing and disabling symptom.

Physiotherapists can help by teaching:

• breathing techniques
• relaxation methods
• ways to pace activities
• daily activity management.

They can also help if you are finding it difficult to clear chest secretions.

Pain

Pain can be complex and may have many causes.

As part of the wider multidisciplinary team, physiotherapists may help manage pain through:

• exercise
• posture education
• transcutaneous electrical nerve stimulation (TENS)
• heat or cold therapy
• acupuncture.

Exercise

It is important for people with a palliative diagnosis to remain as active and independent as possible.

Physiotherapists can assess your needs and provide a personalised exercise programme. They may also invite you to take part in an exercise group.

Fatigue

Fatigue is a common symptom that can have a significant impact on daily life.

Research shows that exercise is one of the most effective ways to manage cancer-related fatigue.

Physiotherapists can assess you and develop a suitable exercise programme.

Physiotherapy groups

Living Well Circuit Group

The Living Well Circuit Group is a weekly exercise session held in the physiotherapy gym at Wisdom Hospice.

The one-hour session includes:

• upper body exercises
• lower body exercises
• cardiovascular exercise through a range of activity stations.

Exercises can be adapted to meet individual needs.

The programme runs for six weeks. People who find it beneficial may rejoin the programme.

Fatigue and Breathlessness (FAB) Group

The Fatigue and Breathlessness (FAB) Group is a three-week course with one 90-minute session each week.

Participants are encouraged to attend with a family member or carer.

The course covers:

• anatomy
• breathing techniques
• exercise
• nutrition
• fatigue management.

We help patients and their families by addressing practical and financial issues that arise when coping with advanced illness.

Our palliative care welfare advisers offer confidential advice and support to people affected by serious illness and bereavement.

If you have an advanced progressive illness, or you are a carer there are a number of benefits to which you may be entitled. We can help identify which benefits are appropriate and can assist with applications.

We have immediate access to a charitable fund to provide small emergency grants. We also offer advice about claiming larger charitable grants, housing benefit applications and basic advice around debt issues if appropriate.

Sharing your information

Following the principles within the General Data Protection Regulation (GDPR), MCH processes your data for purposes of:

• provision of health or social care or treatment medical diagnosis
• preventative or occupational medicine
• management of health or social care systems and services, carried out by, or under the supervision of health professional or another person, who in the circumstances owes a duty of confidentiality under an enactment or rule of law.