www.dyingmattersleicestershireandrutland.com has been designed to act as a signpost, to help you find out what services are available to you, when you might need them. This month, our focus is on Home Straight, a home care company in Oakham with a difference. To find out more, we spoke to Stevie Katsouris, Managing Director at Home Straight who told us about the care service they provide to people who are approaching their end-of-life and how Home Straight have made it their priority to ensure that their clients can have their best end-of-life possible.
Many people know Home Straight for the personal home care service they provide to elderly people and vulnerable people in the community, which enables many of their clients to stay at home and remain independent as long as possible. Home care includes help at home with a wide range of tasks such as, ironing, shopping, cleaning, cooking and other general household tasks that have just become too much for their clients. In addition, they offer personal care, companionship and rest bite respite care for people who are caring for someone at home. But what few people know is that Homes Straight have been able to make a real difference to clients and their loved ones during their end -of-life by helping to ensure their clients can die peacefully at home and with dignity.
It has been estimated that over 80% of people in the UK would prefer to die in the comfort and safety of their own home, rather than in a hospital, but despite this, around 50% of people still die in hospitals. Not surprisingly, one of the most important factors determining whether you can die at home, is whether you can be cared for at home. With an aging population and a high number of complex needs, it has become increasingly challenging to support people who wish to die in their own home, rather than in a hospital.
Providing care to someone who is approaching their end of life can be a complex and demanding job, which requires training and experience. The carer needs to be able to recognise when people are in the last year of their life and be able to encourage them to talk about their end of life wishes. Understanding what they would like their end of life to be like and what detailed things might make them more comfortable is key to their care. It is a difficult, but important discussion to have, particularly as there may come a time when someone is no longer able to communicate what their preferences are.
At Home Straight, every client is encouraged and helped to put an advance care plan in place. Advance care plans are very comprehensive plans that record your care and treatment wishes in detail, including where you want to receive care, where you want to die, who you want to be with and what your religious or spiritual preferences are. An Advance Care Plan will also contain information relating to next of kin, emergency contact details, the language you speak, current health issues, and expected emergencies, as well as a list of the medications you might need or and any allergies you may have. It is a mini summary of your current healthcare needs and is often done hand in hand with a ReSPECT form.
Advance Care Plans are created by GPs or health care professionals who are trained to do so. The advantage of having an Advance Care Plan is that they can help GPs and out of hours doctors or hospital teams guide their decisions based on patient's wishes. It also helps ensure that someone can have access to palliative medical care and it can also help prevent unnecessary emergency hospital admissions, which is very important for someone who would prefer to die at home.
Being able to start sensitive conversations about dying requires training and experience. This is one of the reasons why carers who work at Home Straight are offered ‘Gold Standard Framework Training,’ The training highlights the many choices people have to make when they plan their end of life and helps carers to identify and keep up with the changing needs of their clients. At Home Straight, many of the carers work in small teams and they tend to work with the same client over a longer period, which means that they get to know their clients very well. Stevie Katsouris often uses an analogy to help their carers understand what is truly important to a client by asking them “what would this client have in their handbag“, which is really another way of saying, what really matters to them? It’s the fine details in their personal care that really matter, right down to what shampoo or makeup someone might prefer, how they would like their bed to be positioned in the room, which personal items might give them comfort, or what is their favourite tipple they might want at the end of a long day.
Although end of life caring can be challenging, the care teams see it as a privilege to look after someone during their end of life, especially when they know they have been able to make a difference. Malvina, who has worked at Home Straight for 5x years described a client who desperately wanted to be able to die at home, in the comfort of her four-poster bed, but her medical staff were very reluctant for her to stay at home and preferred her stay in hospital. Their concern was that she might suffer from bed sores and infections., due to her lack of mobility The Home Straight care team were able to reassure the medical team by providing the round the clock care she needed. They ensured she was helped to move regularly and as a result, the lady was able to die peacefully and with dignity in her own bed, just as she had wanted.
It can be very hard to lose a client, especially when you have cared for someone for some time, which is why the care teams at Home Straight are given additional support through reflective practice (Schwartz Round). Reflective practice allows the care team to share their individual experiences of loss and get peer support. It also helps carers to learn how they can protect themselves emotionally, which is important. Home Straight is the first home care agency to offer thisSchwartz Rounds practice to its care team.
The final question we wanted to ask Stevie Katsouris is what readers should know, to help ensure they can have the best end of life possible. Stevie commented “The more prepared and open you are about discussing what you would like during your end of life, the easier it will be for people who care for you and for the loved ones you leave behind. It will give your loved ones great comfort to know they have done the right things for you and that they have given you the end of life you wanted.”
For more information about Home Straight, visit www.home-straight.co.uk.
For information about the quality of care provided by Home Straight, please contact the Care Quality Commission.
For more information about end-of-life planning you can contact your GP and visit the 'preparing' section on this website.