While hospitals, hospices and nursing homes all provide valuable support services, many people wish to remain in familiar surroundings during their final weeks or days. They may also be unable to cope with the stress and emotional upheaval of needing to leave their home behind as they approach the end of life.
Compassionate, respectful end-of-life care in your own home provides an alternative, with qualified carers who work alongside other healthcare professionals and family members to provide gentle palliative and end-of-life support, ensuring each person remains comfortable and safe.
What Does End-of-Life Care at Home Involve?
One of the often misunderstood aspects of home care services is that they are fully adapted to the needs and wishes of the person and their loved ones.
That could involve ongoing palliative care services if the individual has a life-limiting illness but is not approaching their final days immediately, or sensitive care for those who are not expected to have long left to live.
Every care plan is created alongside the families who know the person best, especially if they are less able to voice their preferences or explain their routines, and may include:
- Personal care, helping with washing, dressing, bathing and continence
- Pain management and help with administering medications
- Emotional support and companionship care services to ensure the person is never alone
- Help with meals, hydration and nutrition
- Overnight care or live-in care services if they would like a carer to be there throughout the day or night
- Practical household support with cleaning, laundry and pet care
Because home-based end-of-life care is person-centred, it is up to each individual and family how and when their carers offer support, and, unlike hospice care, they retain the right to continue familiar routines for as long as they wish and are able to.
Who Is Involved in End-of-Life Care at Home?
Many families worry about whether home-based care will ensure their loved one receives the right medical attention, pain management and specialist support they might expect from a hospice, hospital or nursing centre.
Importantly, healthcare assistants and experienced end-of-life carers don’t work in isolation but collaborate with the health professionals involved in each person’s care. That could include their GP, district nurses and community nurses, local palliative care teams, hospice specialists, occupational therapists, and family members.
There may be scenarios where home carers are asked to step in on days when district nurses or hospice care teams aren’t able to attend, when family caregivers need to rest, or where we supplement care provision at home that might be being funded by the local authority.
Home carers aren’t there to replace medical professionals but to become part of a person’s wider care team.
This ensures everyone understands the person’s wishes and changing care needs, and can respond accordingly if, for example, they require stronger pain management, symptoms change, or they need more involved support.
Why Families Choose Care at Home During a Loved One’s End of Life
The right end-of-life care services will depend on each person’s wishes, well-being and needs, but the value of at-home support, in contrast with moving to a nursing or care home, is that in-home care services remove any need to change routine or try to settle into unfamiliar surroundings during the final weeks of life.
Care recipients can spend time with friends and family, with complete control over who visits and when, without leaving behind their neighbours or community. Although their mobility and well-being may depend on the nature of the terminal illness, many people who receive palliative care may remain able to:
- Spend quality time with their loved ones without limited visiting hours.
- Maintain their routines, deciding when to get up in the morning, when to go to bed, when they might wish to eat or what music they might like to listen to.
- Look after pets with the help of their carer, ensuring people and their companions do not need to be separated during such a difficult time.
- Attend meals with family members or invite loved ones to their own home with the right support with mobility, to manage pain and ensure they can return home to rest whenever they wish.
End-of-life and palliative care focuses on providing holistic support based around the person, which means they can spend their last moments entirely as they would like.
This may be equally important for families, who might need to think about home adaptations such as having an adjustable hospital bed, mobility aids, medication delivery devices alongside care support.
Having a carer there to offer respect and emotional support, answer questions and provide practical guidance can make a significant difference. In addition, bereavement support from a care professional who knew and cared for the person may also be beneficial when the time comes.
Advice for Families Choosing an End-of-Life Home Care Provider
Caring for people nearing the end of life can be emotionally and physically exhausting. Families who receive professional care at home often find this gives them the capacity to rest, spend meaningful time together, and treasure this time, rather than acting as full-time carers.
There are many things families might prioritise, but we’d suggest looking for a team with expertise providing psychological support for both care recipients and families, who can offer:
- Personalised care plans with communication with healthcare professionals and other social care professionals as well as the individual and their loved ones.
- Full CQC regulation and experience working with NHS teams and other services such as Marie Curie nurses.
- End-of-life support that is based around compassion, kindness and continuity.
Each family may be dealing with different circumstances, and there isn’t one end-of-life care structure that will be right for everyone.
If you’d like more information about anything we’ve mentioned here, or want to know what the options are, you are welcome to get in touch with the Guardian Angel Carers team for a discussion about your loved one’s needs and how personalised home care can support both you and your family.