Some people may prefer to be cared for at home in familiar surroundings with the people they’re closest to. However, terminal illness can be unpredictable and there may be times when your friend or relative might need more care than you can provide. This can be especially difficult at night or in the early morning when their usual healthcare professionals might not be available.
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If you’re worried about what to do during these times, or just want some reassurance, you can get in touch with your local out-of-hours (OOH) service. It’s a useful source of health advice and support and there doesn’t have to be an emergency for you to contact it.
Out-of-hours care is there to take care of your friend or relative’s needs outside of the regular healthcare team’s working hours. Normally this is from around 6:30pm to 8am on weekdays and throughout weekends and bank holidays when regular health services might not be available. Different types of care make up the service and your friend or relative might be treated by some or all of the following:
- a GP from another practice
- healthcare teams in primary care centres, accident and emergency, minor injuries units or walk-in centres
- health workers (other than doctors) making a home visit
- ambulance services that will bring you to a doctor or nurse
You should consider contacting out-of-hours services if your friend or family member has symptoms that you can’t manage, like extreme pain or agitation, and it’s too late or early to contact their usual doctor or nurse. You can also get in touch if you’re worried and want some reassurance. The service is there to help and you shouldn’t feel as if you’re bothering healthcare staff by getting in touch.
Getting access to out-of-hours care is straightforward and if you ring the GP surgery outside of its regular hours you should be directed to the service. Sometimes this may be a recorded message with more details on who to contact, so it might help to have a pen and paper handy.
You can also call NHS 111 / NHS 24 (111) in England and Scotland, NHS Direct Wales (0845 46 47*) or in Northern Ireland visit nidirect for a list of out-of-hours contact details in your area.
In an emergency, ring 999.
When calling an out-of-hours service, you may be asked some questions by an adviser so they can get you help. They then decide who you need to be put in touch with and can arrange a call back or house call from a doctor, nurse or other health worker. Services like NHS 111 can also send an ambulance if needed.
You can ask your GP to send a summary of your notes to the out-of-hours service so they can be prepared in an emergency.
You may feel frustrated at being asked a lot of questions when someone close to you has difficulties. Try to stay calm and give the out-of-hours service all the detail that you can. If you’d rather not speak to them, you could ask a family member or carer to contact them instead, although you may want to stay nearby during the call to answer questions that they can’t.
If your friend or relative prefers to stay at home while they’re being cared for, they may not want to go to hospital. It’s important that their wishes are made clear and having a care plan in place will help with this.
Depending on how their symptoms are managed, they may have to go to hospital as a result of contacting out-of-hours care.
Managing symptoms at home
Being able to manage symptoms at home can help with avoiding an unwanted admission to hospital. In some cases a syringe driver can give a steady amount of medication to keep your friend or relative comfortable.
It may also be possible to get a Just In Case box from the NHS in England, Scotland and Wales for home use. This can contain medication for breathlessness, agitation and breakthrough pain. It might have another name in your area, so ask your doctor or district nurse for details. Your district nurse or doctor may be able to arrange something similar if you live in Northern Ireland.
Marie Curie specialises in overnight care and can arrange for an experienced nurse or healthcare assistant to be there for your friend or relative. They can help by administering medication for symptoms, giving emotional support and letting you have a chance to get some rest.
This kind of care is not an emergency service and is usually organised in advance, but a Marie Curie rapid response service is available at short notice in some areas. Your district nurse will be able to help you with arranging care from a Marie Curie Nurse.
*Calls are free from landlines and mobile phones. Your call may be recorded for quality and training purposes.
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