160 APPEAL: Ensuring that life still has a meaning
ALLEVIATING the suffering of patients is the consultants’ utmost priority at Prospect Hospice as is their strong and immediate focus on life as opposed to the inevitable death of each of their charges.
The Wroughton charity counts on four doctors, two consultants, two experienced GPs with a special interest in palliative care and a pair of junior doctors – who join the team for four month stretches as part of their training – at any one time.
The small team tackles a monumental task caring for hundreds of patients each year in the hospice’s in-patient unit, out in the community and at the Great Western Hospital, where they assist staff and share their expertise on the complexities of palliative medicine.
Contrary to popular belief, their role and health mission revolves, like any other medical practitioners, around ‘living’ and ensuring, through symptom and pain management that patients live as long, independently and happily as they possibly can.
“All our patients have advanced or progressive conditions but they may be some way from that dying phase and a big element of what we do is managing symptoms,” said Dr Kate Tredgett, a specialist in palliative medicine.
“When people talk about palliative care they think it’s an environment with no hope.
“But it is very much about living as well as possible as long as possible and it is as much about living as it is about dying. Although we acknowledge that it will be the final outcome.
“For some patients it is about living well with the condition. About half of patients come in because they are dying but the other half come in because there is something active we can do to improve things for them.”
Far from isolated entities, consultants are an integral part of the wider healthcare system playing a crucial role in educating and assisting hospital staff, for example.
Kate added: “We proactively work alongside people at the hospital because our patients will often be receiving treatment like chemotherapy alongside being seen by us. We enable them to deliver care, educate them, and provide advice.
“And we see patients wherever they are and wherever they need support. We also see them at home. We are this extra tier of expertise to the clinical nurse specialists.”
A large part of palliative care involves providing psychological, social and spiritual support alongside medical expertise. This holistic approach means the focus is on the patient as a person and not simply a set of symptoms. By extension carers and family members also build a strong bond with consultants and themselves and too receive emotional assistance from the team.
Prospect Hospice doctors, left to right, Dr Nicola Stephens,
Dr Kate Tredgett and Dr Helen Eckley
Dr Helen Eckley, a GP specialising in palliative care, works solely on the in-patient unit.
She said: “We are fortunate in that we are able to spend quite a bit of time with each patient and GPs would not be able to do that. It means that we can support them much more psychologically. A lot of issues come up about life after death. People also look back on the meaningfulness of their lives and the things they have achieved or that they regret and we are there to support them.
“It’s a really important relationship with the patient and the family that we develop right when the patient first comes in. A lot of what we do is trying to support the family just like we are trying to support the patient in how they are managing what is happening.
Kate added: “Palliative care values people as a whole, it’s about the whole person not just their physical illness. It’s about the spiritual, social, physical and psychological and if one of these is out of kilter patients can experience distress.”