Hospice at Home

Our Hospice at Home service supports patients who are in the last six weeks of their illness to die at home, free from pain and surrounded by their family and friends.

Care is normally provided in the last six weeks of life and regardless of diagnosis.

Aims and Objectives

  • To enable adults to remain at home in the last weeks of life, regardless of diagnosis, if this is their choice.
  • To work closely with their key worker – usually a Community Nurse and plan the care required and review on a daily basis.
  • To offer support to colleagues in the community.
  • To meet the physical, emotional and spiritual needs of patients during the last weeks of life.
  • To audit and develop the service in line with service users requirements, and local and government guidelines.
  • To facilitate reduction in the numbers of unnecessary admissions to hospital/hospice/nursing home in the last few days of life.
  • To allow discharge from hospital/hospice/nursing home in the last few days of life, enabling preferred choice of care/death.

Referral Criteria

  • Patients must be registered with a GP practice within Shropshire County or Telford & Wrekin CCGs, or be registered with one of the following GP practices in Wales:

    Knighton

    Llanfyllin

    Llanfair Caereinon

    Llanidloes

    Montgomery

    Newtown

    Presteigne

    Welshpool

    Machynlleth

    Cemmaes Road

  • Patients can be referred regardless of diagnosis, but must be in the palliative or EOL phase of their illness.
  • Patients should be in the last 6 weeks of life, and have palliative care needs (we are aware that this is difficult to assess).
  • Patients must have expressed a wish to die at home.
  • Family and carers must be in agreement and able to support this.
  • An up to date care plan must be in place, and for the terminal phase an end of life plan is required.
  • The patient must be flagged to the out of hours medical service i.e. Shropdoc or equivalent OOH service.
  • The minimum request for care input should be 2 hours.

 

 

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