Archive: September 3, 2020

The role of the family during end-of-life care

Caring for a loved one during the final stages of their life may be an exceptionally challenging experience for the patient’s family and close friends. While palliative care, like the service provided by HospiceWits, certainly helps to make that load a little lighter, the people close to the terminally ill person often wonder how they can contribute.

The involvement of the family is especially important in the context of end-of-life care, and there are definitely ways in which those close to the patient can assist the HospiceWits interdisciplinary team. The most important way in which they can help is simply by being there for their loved one who is experiencing the last part of their lives.

Firstly, the family plays an important part when the team from HospiceWits draws up a patient care plan, as they are able to assist in creating a plan that is in accordance with their loved one’s wishes, and takes all their needs into consideration. Family members are unique contributors in this sense, because they probably have the clearest understanding of just what their loved one wants and needs at this time of their life.

As soon as the way forward has been established, the next of kin need not worry about the medical and psychosocial aspects of their family member’s end-of-life care, as this is undertaken by a highly qualified and experienced team. The family should continually update the care team about the patient’s condition.

With this being said, the siblings, parents or children of the person who is receiving palliative care are essential with regard to supporting their loved one as they reach the end of their life, even if that patient seems unresponsive. By giving and receiving love and reassurance on this last journey, terminally ill patients are assured of the impact and contribution they have made for others over the course of their life. For many patients receiving palliative care, this is something they really want to know as they reflect on their days spent on earth.

Family members can reaffirm their love for the patient by paying regular visits, sharing special memories, holding their hand, providing a comforting touch, and lending a listening ear.

When the patient passes away, the psychosocial support team – who will have been assisting both the patient and their family with mental care services – will provide grief, loss and bereavement counselling to their loved ones, helping them to grieve in a way that still recognises the important part their late loved one played, and celebrates their life.

HospiceWits’ specialist psychosocial team, dubbed Sihlangene (which means “we stand together” in isiZulu), consists of a qualified general practitioner with a postgraduate specialist qualification in palliative medicine, a psychiatric nurse specialist and a diverse group of counsellors hailing from various training backgrounds and with varied experience, together with experienced frontline workers, management and coordinators. Sihlangene’s services utilise a variety of methodology and approaches, and offer one-on-one counselling or family meetings at its offices, online remote counselling via Skype or Zoom as well as telephonic and WhatsApp support.

Click here to find out more.

This is what HospiceWits’ interdisciplinary team does

HospiceWits provides care and support through a holistic, interdisciplinary team approach, with the provision of palliative care for all in need.
The interdisciplinary team provides a complementary approach to palliative care, supporting not only the patient, but also extending a hand to their family and other loved ones.

The team consists of a doctor, nurses, social worker and other counsellors. We also facilitate specific denominational spiritual care, should it be requested, as well as the services of other health professionals like physiotherapists to assist with specific patient needs.

The following is a breakdown of the roles of each team member:

Physicians or General Practitioners

The Physician/GP oversees the medical care of the patient, and communicates with the family and the rest of the care team regarding the patient’s medical condition. They provide treatment recommendations and assess the benefits and side effects of their medication. The Doctor is responsible for prescribing medication and other forms of treatment.

Nurses

Nurses administer medical care to patients according to the recommendations made by the Doctor. They offer direct care to the patient and often serve in a supervisory role with regard to nursing assistants and other members of the care team. The nurses also update the family about the patient’s condition.

Nursing assistants

Nursing assistants help with other aspects related to the care of the patient, and provide personal care like feeding, bathing and assisting with ablutions. They also monitor the patient’s vital signs, regularly checking their pulse, temperature and blood pressure, and provide this information to the Nurses. Home-based care Nurses provide care to patients in the comfort of their own homes, under the supervision of the Doctor.

Social Workers and Counsellors

Psychosocial care plays an important role in palliative care. Social Workers and trained Counsellors are indispensable in this regard, and help to relieve emotional distress through specifically tailored counselling methods.

The HospiceWits In-patient Unit

HospiceWits’ In-patient Unit in Houghton provides a home-from-home environment for patients in need of short-term, specialised palliative management and symptom control.

Dr Craig Howes oversees patient care in the Unit, and he is capably assisted by a team of compassionate and caring registered and auxiliary nurses. As an experienced palliative care doctor, Craig’s gentle nature is perfectly suited to his role. Caring and empathetic, the talented doctor is a good listener who speaks the patient’s language, and spends as much time as is necessary with patients, their families and staff in the Unit.

The daily routine includes a ward round with Dr Craig and the sisters on duty. The condition of each patient is carefully assessed from engagement with and feedback received from the entire interdisciplinary team, as well as the family. We see families as extensions of the patients, and they are welcome to be with their loved ones as much as they want to. The Unit offers a comfortable lounge with kitchen facilities for family members where they are welcome to make a cup of tea or coffee and heat up a snack to enjoy when they need a break. A family member is also able to spend the night with their loved one, should they wish to do so.

During the course of each day, Dr Craig will make decisions about the best possible care for each patient. He meets with each family every few days to discuss the condition of their loved one, and makes suggestions for future care. These meetings also provide an excellent opportunity for the doctor to counsel the family.

The focus of hospice care is not purely physical. It incorporates medical, psychological, spiritual, emotional and cultural needs. Besides Dr Craig and the registered nurses who counsel patients and assist grieving families daily, we are fortunate to have a number of very special, trained counsellors and social workers, who give of their time voluntarily to provide comfort and support for those who are not coping with the reality of their situation. A few of our counsellors have had their own personal experience with hospice and have a strong desire to give something back for what they received in their time of need.

HospiceWits also facilitates specific denominational spiritual care, should it be requested, as well as the services of other health professionals, like physiotherapists to assist with specific patient needs.

Our registered nurses are responsible for, among other things, the general nursing care, assessing the condition of each patient hourly (or more), as well as the administration of medication. The auxiliary nurses work as a team and tend to patients together. Their responsibilities include feeding, bathing, changing, toilet assistance, dressings, mouth care and being with confused patients to ensure they do not injure themselves. They are constantly ensuring patients are as comfortable as possible, and that their every need is met.

The people that make up the HospiceWits interdisciplinary team are committed to providing dedicated support and assistance to patients and their families. Years of experience have taught each member of our care team how to provide exemplary service that takes the specific needs of each patient into account.

To learn more about our palliative care approach, click here.