• Wigan peers 23 April 2018 | View comments

  • 23rd April 2018 | By David Jolley

    Wigan and Leigh’s Hospice is a special organisation. http://www.wlh.org.uk/

    Here it was, quite a lot of years ago, that Dr Mary Neal (previously Harrison) became Medical Director – having moved on from her post as Consultant Geriatrician in Crewe. Mary had married David who was the Consultant Psychogeriatrician in Crewe and both were close friends to our family. So the hospice has a treasured place in our hearts.

    It is a special place and latterly is leading the world in transforming end of life care for people living and dying in nursing homes. Our approach at Willow Wood Hospice for Tameside and Glossop has been to add a specialist service for people with dementia to the spectrum of services provided by the hospice. This means the palliative approach to dementia diffuses across all the places people are living and dying with dementia: home, hospital, care homes or hospice. This is a model we learned from St Christopher’s Jan Scott and Victor Page. It works well and has much to commend it but it has not proved as popular with commissioning organisations as we would think right. There are only 15 such services nation-wide – a static figure over several years.

    Wigan and Leigh’s model is different - it has developed a special relationship with a group of nursing homes – I think there are about a dozen registered to the scheme and the number is growing. The model is of ‘hospice in your Home’ – providing education, training and care which enables people approaching the end of life with dementia, cancer or whatever mix of pathologies have come to them, to receive competent, confident palliative care to the end in the place that has become their adopted home.

    It was good to hear the presentations from hospice staff, from a nursing home manager, and from two brilliantly determined women living in the nursing home and carrying evident pathologies. Both spoke positively of the benefits of having completed an advance directive. They now feel in control of their futures.

    We heard of the practical issues which crop up, including the decision to register residents with one, interested local General Practice. Even so, keeping to plans is not always straight forwards when needing medical support out of hours.

    There are huge advantages in hospice in your Home for patients, families and staff. Commissioners are impressed by the reduced use of general hospital admissions. We know that St Christopher’s is doing something similar and that many other hospices are looking at adopting this model. Three cheers for Wigan and Leigh.

    Of the other presentations I caught, one was an inspirational reflection from a retired nurse lecturer who lives with a diagnosis of Alzheimer’s disease ten years on and remains busy and helpful to others. The other aimed to clear the mists of doubt and confusion which sometimes cloud the use of DoLS.

    Won’t it be wonderful when the government gives the go-ahead to the Law Commission’s suggested alternative!

    So this day of study and learning has become a part of the hospice in your Home project. The people attending are mainly from the nursing homes, but also from primary care and other community agencies. There is a real sense of community. I would encourage other hospices and localities to look at what is being done here, but would still argue for a hospice-based palliative care service for people with dementia across the full range of settings where they are housed – complementing that focused on nursing homes. While we hear that 90% of people with dementia in Holland die in nursing homes, this is the case for only 60% in this country and many of those dying in such care have moved there quite recently. Wrapping them round with the cloak of hospice competence before that makes for an easier passage.

    « Back to archive
  • Leave your comment

  • Name:
    Enter the code shown above: