A day in the life… Willen at Home
Our Trusts and Foundations Manager Ellie Walsh recently spent the day with one of our Willen at Home nurses, Amy. Here’s what she discovered…
When people hear ‘Willen Hospice’, they often think of our In-Patient Unit and although this is an integral part of our charity, we also support around 400 patients a year in the community. Recently, I was invited to shadow Amy, a Clinical Nurse Specialist from our Willen at Home Team, to understand more about their work in the community.
As we drive to see Amy’s first patient, the conversation flows easily – you can tell she is used to speaking to people from all walks of life. As soon as Amy enters the bedroom, her priority is to make the patient feel at ease. She kneels beside the bed, holds the lady’s hand, and speaks to her with kindness, giving the patient a chance to process what she is saying and reply. Although the patient is struggling to speak, Amy looks for other signs, no matter how subtle, to ensure she is comfortable, not agitated, and pain-free.
On our way to the next patient, Amy explains how they are increasing support for patients who don’t have a cancer diagnosis – in the last year the CNS’s have taken on a specialism, such as neurology or renal, to improve the diversity of our support. Amy’s specialism is frailty, which is particularly important for Milton Keynes as the population is estimated to grow from 260,000 to 300,000 by 2026 and, within this, is predicted to see the fastest growth in the number of over 65’s in the UK – a 77% increase by 2030.
Lacking knowledge in how frailty is a specialist palliative need I, rather clumsily, ask Amy how it fits with the care we offer. She explains how frailty can be a cause of death; for those in their eighties, nineties – even centenarians – it means losing the ability to bounce back and, as a result, deterioration occurs because they are unable to fight off illness. She tells me about a conference she attended last year, where an expert in the field of care for older people said those with frailty may look fragile and vulnerable but they are the strongest people of their generation. This completely changed the way she thought about her patients. Over the next few years she is hoping to develop new projects and initiatives to better reach and support frail older people in the local community.
We visit Amy’s next patient in her own home; she instinctively knows these early meetings are about building a rapport; she converses with her effortlessly and sincerely, weaving in and out of conversations about her life – family, jobs and holidays – to her care and symptoms. Our CNS’s are able to give people their time. They aren’t rushing to their next appointment, they can sit with the patient and offer their full attention. They get to know them and their families, learn more about their support networks, what’s important to them, and uncover any goals they wish to achieve. I can’t help but think this must be important later down the line, when people are dying and their relatives are caring for them – having someone they trust at the end of the phone, someone who can visit them quickly – must give people, who wish to remain in their own homes, the confidence to do so.
When you visit a patient with a Willen Hospice Community Nurse you can’t help but feel they are in the best hands possible. Patients relax. They feel able to ask questions, share their experiences, and talk about dying with an ease you don’t witness in everyday life. The visits address patient choice and, for when the time comes, the practicalities of where, how, and who – including the benefits of being admitted to the In-Patient Unit versus the independence and familiarity of being cared for at home. And it isn’t exclusively about the patient – those in caring roles, formal and informal, have input and the opportunity to ask questions too. Amy’s expertise helps people with the challenges of complex pain management, symptom control, and mobility – ahead of time – to prevent a crisis and to plan for the journey ahead.
Find out more about Willen at Home and how we care.