Inspirational Stories

Hospice Care in the Home

Warm and caring and with an extraordinary talent for putting people at ease, Jan Wickens has spent the past twelve years working for the hospice. She is one of a special team of nurses who go out into the homes of patients who have a terminal illness to care for them.

I’d been a midwife for nine years, dealing with the beginning of life, then I worked for eighteen months as a theatre nurse but I missed the personal contact with people. A job came up at the hospice and I thought, let’s just go from one end of life to the other.

I get a lot of satisfaction from my work. We do a lot of empowering for the patient and their families. I often meet people who are very apprehensive about what hospice is and what we are going to do. They fear what’s going to happen in the future and how they are going to manage. But just by being there and giving them support I find it’s very rewarding to see how families and patients do cope with what’s happening to them.

When we are in the home we focus totally on the patients and their families. Sometimes we just sit and listen. Other times we deal with their symptom control. We monitor any pain or nausea, making them comfortable and we’ll address any other symptoms that may be concerning them. We do hygiene care as well - for example if someone can’t get out of bed we’ll wash them. We liaise with their GP or the district nurse to provide the best care we can and that care is unconditional.

I’m always aware that we are there as guests at their invitation. It is a real privilege to care for someone who is dying and to go into their home. We always acknowledge that the patient and the family have their own beliefs and values and we are always respectful of those.

People often ask what dying is going to be like. TV and films don’t help. There’s always this huge drama connected if anyone dies and it’s often violent. In my experience it’s not like that. If we can get people’s symptoms controlled and they are in a good space then usually its very gentle.

You can become very attached to some of the patients and their families. There was one woman who I was very involved with when her husband was dying ten years ago. She was Mexican and she came out here with her husband. They hadn’t been married very long. We built up a friendship. After he’d died she decided to go back to Mexico. Between selling her house and moving back she had nowhere to go, so she stayed here with me. Since then both my son and my daughter have stayed with her in Mexico. Just a couple of days ago she sent me an e-mail and she said she had never forgotten the impact, the difference the hospice care made.

Many patients are very apprehensive to begin with, so it is important to build up trust. I had one man who was not happy with having hospice care. He shouted and thumped chairs. I sat quietly and did absolutely nothing for about half an hour. When I left I said I would like to come back and see him again. He said that was fine as long as we didn’t talk death and dying. So I started visiting him on a weekly basis and we talked about the garden and his vegetables and the like and as time went on we became good friends. When he did die, we were there to manage his symptoms - and the trust and friendship had already been established.

You know that everyone you meet is going to die. Sometimes its days or weeks, sometimes its months or years. The longest person we have on our books is for ten years. That doesn’t happen often, I might add, but now and again it does. We are getting more patients in their twenties, thirties and forties lately - something that is more difficult. So the job isn’t easy. We have monthly supervision where we can off load if we have problems. I also get a lot of help from the other nurses - we are all very aware of the need to support each other. I also think you’ve got to have the fun times and the quality times away from work to balance the sadness. It’s good to have a balance in life.