Summary
The Carers Choice Service allows carers of people with palliative care needs an opportunity to have a short break from caring and allows carers to access a choice of hospice therapeutic services as well as accessing social, leisure and recreational activities which enhance their caring role.
What Carers Choice Befriending Service did
The Carers Choice Service is advertised on the Hospice website and Facebook page. Leaflets are also available to carers and patients, offering information and advice on how to refer. The service is managed by a Senior Charge Nurse and 2 Support Workers who are responsible for delivering the service and supporting the volunteer befrienders. Volunteers are recruited through volunteer centres, social media, newspaper and our initial cohort of hospice volunteers. A robust training programme was completed by volunteer befrienders in year one, and we have repeated this process, recruiting new volunteers annually, with all volunteer befrienders participating in a final interview.
Hospice carers are supported by offering a volunteer befriender to sit with the patient for 3 hours once a week, over an 8-week period. This can be increased to 16 weeks at the carers request. If carers still require the service thereafter, they can be re referred. Carers use this time to catch up with family and friends and to access social, leisure and recreational activities which helps them have a short break from their caring role. Alternatively, it also allows them time to access therapeutic hospice services.The volunteer befriender carries out a purely social role, allowing the patient time to spend with someone else out with their family. The befriender remains in the house with the patient and participate in activities such as readiing, chatting , or offering a theraputic hand and arm massage.. Carers are referred to the service by hospice staff, who identify patients and cares who would benefit from this service.
During the pandemic, the befriending service had to become more innovative, befrienders continued to offer support, via virtually or by phone. A closed Facebook page was developed for hospice patients and carers. Participants have access to Time to Chat, where they can spend an hour a week gaining support from hospice staff, and peer support from other participants. Also advice and information is posted daily online. For people who do not want or can not access the virtual facebook page, a monthly news letter is sent out.
What The Prince & Princess of Wales Hospice has learned
A realisation that carers don’t always recognise themselves as carers, there may be many people involved in caring for one person. Carers could be family members, friends and neighbours, all involved in supporting the one person, usually to remain in their home.
Carers services have to adapt to continue to offer support. Teams have to be innovative in their approach especially during pandemic times, and continue to look at what has worked well and what will continue to be taken forward in the future.
Partnership working is key especially in pandemic times, when patients and their carers are so isolated. This should be with not only internal teams but teams who are still working in the community, and able to reach our patients and carers.
How The Prince & Princess of Wales Hospice has benefitted from the funding
This funding has allowed us to develop a robust service for carers. During the periods of funding we have used quality improvement techniques to respond to service evaluation and feedback to continually develop and expand the service in the true spirit of co-production.
The funding has also allowed us to develop a robust training programme that has developed the skills, and confidence of our volunteers allowing them to support our patients and carers in a holistic way.
During pandemic times, our volunteers have had the confidence to work from home, offering virtual and telephone support to our patients. This alleviates the fears of carers who can not always be with their loved one, as they know their loved one has had companionship, and support on that day. We have also offered tablets for a period of time to our patients and carers, with I.T. support from a befriender when the Tier system allowed.
Project Outcomes
Outcome
55 Carers of Hospice patients living with life limiting illnesses, will have improved wellbeing
Results
The project outcomes were achieved, 60 Carers of Hospice patients living with life limiting illnesses, had improved wellbeing. The hospice offers carers access to wellbeing services such as complementary therapy, counselling, yoga, mindfulness within the hospice.
Many carers benefit from such services, as well as being signposted to other wellbeing services within their area.
During the pandemic, wellbeing classes are offered on the hospice closed Facebook page. This encourages Carers to concentrate on their own wellbeing, and still participate at home.
Case study
Jane is caring for her husband David, she has been in the caring role for many years. She had previously looked after her mother until she died. David has carers who help Jane out, but she is struggling with her own health now. “I have back pain, and i am not looking after myself, as i have no time” David was fully aware that his wife was in pain and felt guilty “ she doesn’t complain, but i know she is sore with helping and looking after me in the house”.
Jane and David agree to a volunteer befriender spending time with David allowing Jane a few hours a week to herself.
Jane said “i went to the doctor and he gave me some advice and medication to help my back, i feel so much better, and after talking to your support worker i now have carers more frequently helping me out” .Jane decided to attend a yoga class once a week with a friend, with time for a coffee afterwards. David noticed a positive change, “its nice to see her getting time to go out with friends, it makes me feel better as well” He also felt a positive change in his own mood with having someone new to talk to. “when Jane comes home, I always have something new to tell her, and she’s the same with me”. They both said the service was “wonderful,” and continued to use the service 3 times, which not only helped to support Jane’s wellbeing, but improved David’s mood.
Outcome
55 Carers of Hospice patients will have the opportunity to enjoy life out with their caring role
Results
The project outcome was achieved, 60 Carers of Hospice patients had the opportunity to enjoy life out with their caring role. Offering a befriender twice a week to Carers who required additional support, helped to sustain a life outside their caring role. For some people this may have been continuing to work, or attend college, or participate in a new activity. Allowing people to maintain their finances, or develop new skills.
Case study
Ann is caring for her elderly fatherJoe who now lives alone , she is also working in a full time job. Ann advised "ive recently taken time off work, as i was so worried about leaving dad on his own all day". " Dad was always used to having mum there, but i worry about him now he is alone". " i enjoy my job, most of my friends are there, so i miss them, i work in special needs, so it is rewarding" Ann and Joe agreed to a volunteer befriender. The befriender visited twice a week, allowing Ann to return to her job on a part time basis. Ann said " its great now, i work on the days the befriender is with dad, hes here in the afternoons, after the carers leave, so i know hes safe". Ann added "im so happy being back at work, spending time with my friends and the children, i couldnt imagine not being able to work" Joe felt safe with the befriender visiting twice a week, " Ann can go to work now and know im safe, i dont worry now if anyone comes to the door or i need a cup of tea, its great having John here". Ann said " its a great service, knowing i can ask for help to let me go back to work, has been amazing, and i feel better knowing dad enjoys the company".
Outcome
55 Carers of Hospice patients will feel better supported to sustain their caring role
Results
The project outcome was achieved. 60 Carers of Hospice patients felt better supported to sustain their caring role.
On the initial visit by the Support Worker, a Carers Assessment is completed. This assessment highlighted the need for a befriender, but it also raised awareness of the areas that carers required support with, such as paid carers for their family member, Occupational Therapy, physio and counselling. It also incorporated referrals to Improving the Cancer Journey, where Carers receive guidance on financial support. This assessment maximised the support we could offer our patients carers, helping them to maintain their caring role.
Case study
Paul is looking after his brother James who has had a recent diagnosis of cancer. James has never married and has no family of his own. Paul also looks after his parents who are elderly.
Paul is married with 3 young children and he is busy working shifts. Paul said " im struggling, James can sometimes fall, and his memory is poor" Paul is anxious about his brother, especially when he is working his 3 long days. " I don't know what help is out there, this is sudden". Paul's parents had help from carers throughout the day, but Paul still did all their shopping, "makes me feel better, i can pop in, see if they are ok. Its James i worry about, the change, deterioration" Paul and James agreed to a volunteer befriender, the befriender would visit twice a week, to support the caring role. Paul said " its made a difference, im not checking my phone all the time, checking to see if something has happened, its peace of mind, i couldn't continue the way i was" . "I was trying to look after everyone, and it was getting to me, its made a big difference, i don't worry now, when i know the befriender is with James". Paul was supported by offering a befriender twice a week, and also the carers assessment showed that James would benefit from paid carers being involved in his care in the morning. "Paul said thank you, i never realised the support that was available, i didn't know where to start"Input from the befriending service allowed Paul to sustain his caring role, in a way that was supportive to him as well as his brother.