These decisions have to be guided by what the person really wants as they approach the end of their life, and their wishes must come first.
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If your relative or friend doesn’t already have an advance care plan, now is a good time to make one. The plan can include what someone wants from their care at the end of their life, and what should happen if they become unable to make decisions. It can be written in a document that is sometimes called an advance statement or, in Scotland, an anticipatory care plan. You can ask the doctors and nurses for help with this.
Your own wishes, what you feel able to do, and practical limitations need to be considered, too. Remember that plans can always be changed, and this is OK. Things don’t always work out as expected, and many people change their minds about what they want.
When choosing a place to be cared for after leaving hospital, there are three main options: home, hospice or nursing home.
Care provided by your district nurse, along with other support services, can make it possible for your partner, relative or friend to be cared for at home. Our Marie Curie Nurses and Healthcare Assistants may be able to provide cover at night and this service is free of charge.
If you have any questions or are worried about doing certain tasks, don’t hesitate to ask the nurses before your partner, relative or friend comes home. You can also ask any of the nurses who visit your home later on. You might like to create a folder of nutrition and drinking charts, rotas for overnight nurses and contact numbers so you can quickly find the information you need.
Hospice care is about comfort, peace and support for the person who is ill and their family. Expert nursing and medical care is available around the clock, in a homely setting where visitors are warmly welcomed. Hospices are run by various charities, including Marie Curie. People don’t have to stay in the hospice all the time, and it’s not unusual to have short stays back at home.
Read our article Choosing where you would like to spend your last days for more information about these choices.
This is another option if it’s too difficult or impossible to care for your partner, relative or friend at home. If your relative or friend already lives in a nursing home, they may prefer to return there, where they feel settled and know the staff.
If you and your partner, relative or friend are considering a hospice or a new nursing home, make a visit to see what it’s like. The staff should be happy to answer any questions.
You can learn more about each of these choices by reading Choosing where you would like to spend your last days. This article is written for people who are nearing the end of life so it takes their perspective.
England, Wales or Northern Ireland
Wherever they go after leaving hospital, your relative or friend should be discharged with a written care plan. You may find that many different people become involved in your relative or friend’s care, and it’s vital that everyone knows what they want, and what has been agreed.
This is different to making an advance care plan, which is something that your relative or friend decides with your input if you’re the main person involved in their care.
When your partner, relative or friend is discharged, staff should give you a very clear idea about:
- their medical condition, and how it may change over time
- what care they will need
- who can help with problems, and how you can contact them
Your partner, relative or friend will be discharged from hospital after their healthcare professionals have assessed the care they need. They’ll be given a copy of their discharge document, which gives a summary of their hospital admission details. A visiting social care professional or district nurse will then create a care plan for your partner, relative or friend at their home, nursing home or hospice.
The hospital’s palliative care team can be extremely helpful, especially when your relative or friend is preparing to be discharged from hospital. These doctors, nurses and other professionals are experts in caring for people as they approach the end of their lives.
They can also give you lots of practical and emotional support. For example, they can explain what you might expect in the days or weeks ahead, and help you to put arrangements in place. If they’re not already involved, ask for their assistance.
Once your relative or friend is discharged from hospital, their GP will take charge of their medical care. Even if they are managing well, it’s a good idea for the GP to visit regularly. If your relative or friend has returned home, their care may be shared by a team of healthcare professionals who will work together to meet all their needs. The team may include these professionals.
An occupational therapist
They can visit your home to determine what adaptations and equipment might be needed.
The district nurse
They can provide expert nursing care in your home.
Healthcare assistants or other paid carers
They can help with personal care, such as washing, dressing, and using the toilet.
Marie Curie Nurses or Healthcare Assistants
They can work closely with the district nurse. They may be able to come to your home and care for your friend or relative during the night.
They can advise on dietary needs and ensure your friend or relative has the correct food if they have problems swallowing.
A social worker
You and your partner, friend or relative may need help from different services. Social workers can help you find your way around the health and social care system.
A palliative care nurse
They can visit regularly to advise the nursing team on managing pain, if there is any, and other symptoms. They can also point you towards help with practical problems, and listen if you're worried or upset.
A chaplain or other spiritual adviser
They can offer spiritual support to you and your partner or friend, if you want them to. It doesn’t matter what faith you believe in, or whether you have any religious beliefs at all. They can support you before and after someone has died.
Hospice UK – find UK hospice and palliative care services
Scottish Partnership for Palliative Care – hospices and specialist palliative care units
NHS Choices – planning ahead for the end of life
NHS Choices – Advance statement about your wishes
NHS Choices – NHS continuing healthcare
NI Direct – residential care and nursing homes
This page is for general information only. It's not intended to replace any advice from health or social care professionals. We suggest that you consult with a qualified professional about your individual circumstances. Read more about how our information is created and how it's used.
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