Services providing palliative and end-of-life care in the Northern Trust

This information explains the different health and social care professionals involved in palliative care, and how they can support you.

After reading this information, you may find it helpful to talk it through with your family, and those involved in your care, and decide which professionals could support you at home or in hospital.

It can be difficult to ask for help, and many people feel they should try to manage on their own. However, there is a lot of support available to help you with any challenges you may face.

It’s important that you, your family and those close to you get the support you need, as coping alone can be difficult.

We have also included links to other organisations that can offer support to you and your family, helping you find what is right for your needs.

GP

Your GP has overall medical responsibility for your care while you are at home and can refer you to other professionals to help with any problems you may have. You can talk to your GP about all the options for treating your illness and managing symptoms or any aspect of care that you may be worried about.

If you need medical advice or care out of hours, which cannot wait until your own doctor’s surgery is open, contact your GP Out of Hours Service (Dalriada Urgent Care) on 028 2566 3500 – available from 6:00pm to 8:00am, and on weekends and public holidays. Experienced staff will give you appropriate advice

If you have been assessed as needing home oxygen this can be arranged and prescribed by your own GP, or on some occasions the community respiratory team. This will be monitored and reviewed by your health care professional.

There are palliative care beds in local community hospitals which are managed by GPs. These beds are for people whose needs are less complex. The beds are in Inver Intermediate Care Unit (Larne), Dalriada Community Hospital (Ballycastle), Robinson Community Hospital (Ballymoney), and Mid Ulster Hospital (Magherafelt). A specialist palliative care team also provides support to patients in these hospitals.

District nursing

The district nurse will generally be your identified palliative care key worker and will coordinate your care at home. District nurses are experienced community nurses who work closely with the GP. Where appropriate, they will link with other professionals and services depending on your individual needs.

District nurses will:

Visit, assess, monitor, and support as agreed
Act as key worker to co-ordinate your care to meet your needs
Check and fill your syringe driver if needed, and give injectable medications
Keep in regular contact with your GP and other professionals involved in your care
Arrange extra nursing equipment or services if you need them
Provide support and practical advice to your family and carers on how they can assist with your care

You can contact the District Nursing Service in the following ways:

Monday to Friday, 9:00am to 5:00pm
Contact your GP or call our Call Management Centre on 028 2563 5521
Evenings (after 5:00pm), weekends and public holidays
Contact Dalriada Out of Hours on 028 2566 3500

Hospital Diversion Nursing Team (HDNT)

The Hospital Diversion Nursing Team is an extension to the District Nursing Service. Your district nurse can arrange a planned visit by the team to assist with your nursing care.

If you have urgent care needs outside of normal working hours, you can contact the Hospital Diversion Nursing Team through Dalriada Urgent Care on 028 2566 3500.

The team is available from 8.45am to 10.45pm.

They may also be able to administer intravenous antibiotics or blood transfusions to you in your own home or at clinic, if this has been pre-arranged with your doctor.

Social work

Social workers are trained to support people and their families during difficult times in their lives, which includes dealing with a serious illness. They can help you think about areas you want support with and then look at the available options.

Support can be:

Practical – Managing personal care, checking your finances, helping you keep children informed, making arrangements for the future, getting your affairs in order.
Emotional – Dealing with the effects of illness on you, your family and your relationship.
Social – Housing, keeping up your interests and having enough company.
Spiritual – What’s important to you, your beliefs.

Social workers assess, arrange and provide support and information themselves but also link with other staff and services to make sure you have the assistance you need.

A referral can be made by any healthcare professional involved in your care, including your GP. If you are aged 65 or over, you can also refer yourself directly to your local team.

Physiotherapy

Physiotherapy aims to help you maintain or improve independence. This can reduce dependence on family and carers, encourage the use of self-management techniques and give you a sense of control through achieving your goals. The physiotherapist also plays an important role in management of symptoms such as pain, breathlessness, fatigue and lymphoedema. They will assess your mobility and provide walking aids as and when required.

A physiotherapist can also give you a personalised exercise plan to help improve your muscle strength and mobility.

You can be referred to physiotherapy by any health or social care professional involved in your care.

Occupational therapy

Occupational therapy aims to help you with everyday activities, such as getting dressed, managing the bath, shower or stairs, leisure activities, and helping you to get out and about.

The occupational therapist can look at what tasks you want or need to do, and what makes this difficult for you.

Intervention may include teaching new ways of doing activities, providing equipment or adaptations, information and advice on managing symptoms such as fatigue, breathlessness and anxiety or referring to other professionals, for example, for practical support.

You can be referred by any health or social care professional involved in your care. If needed, you may also be referred to specialist services, such as respiratory or heart failure nurses.

Speech and language therapy

Speech and Language Therapy aims to help you with any difficulties you may have with communication and swallowing.

We can support you with communication by:

Helping you find ways to communicate as independently as possible
Supporting you to stay involved in discussions about your care
Offering advice on practical strategies or providing tools to help you communicate

We can support you with swallowing by:

Helping you manage any difficulties with eating and drinking
Making eating and drinking as safe, comfortable and enjoyable as possible

You can be referred to the Speech and Language Therapy Service by any health or social care professional, or you can refer yourself directly.

Dietetics

The role of the dietitian includes carrying out nutritional assessments and providing advice and information that is practical and tailored to you and your family. Nutrition in palliative care focuses on quality of life, comfort, symptom management and enjoyment of food.

You can be referred by any health or social care professional involved in your care.

Pharmacy

Supporting people with palliative care needs often involves the use of medicines. Everyone’s needs are different, but medicines may be useful to help manage your symptoms.

Medicines can be given in different ways. This might be by mouth, under the tongue, by injection, through a pump or drip, or applied to the skin.

The type of medicine you receive and how often it is given will depend on your symptoms and your individual needs.

Sometimes if there are several medicines it can become confusing about what to take and when. If you have any questions about medicines, you can ask your doctor, nurse or pharmacist for advice.

Marie Curie Hospice Care at Home

Marie Curie nurses and health care assistants provide nursing care and support to people in their own homes. They provide a range of services based on individual need and availability. They work closely with the district nurse with the aim of providing the care that is right for you when you need it most. Their planned nursing services offer overnight care and shorter periods of care during the day. Each visit may vary in length depending on your individual care requirements.

You district nurse can refer you to this service.

Marie Curie Urgent Hospice Care at Home

If you need urgent nursing support or advice outside normal working hours, you can contact a Marie Curie nurse through the Dalriada Urgent Care Out of Hours Service.

Telephone: 028 2566 3500

Marie Curie Companion Service

The Marie Curie Companion service helps with companionship and social support rather than nursing or medical care. This volunteer service provides one-to-one support and companionship for people living with an advanced, life limiting illness.

The companion service can also give carers a break for up to 3 hours a week.

You can be referred by any health or social care professional, or you can refer yourself directly.

Telephone: 028 94 331868 (Monday to Friday, 9:00am to 5:00pm)
Email: Belfast.Mail@mariecurie.org.uk
Web: Marie Curie Companions

Marie Curie Information and Support

Marie Curie offers a telephone support line for people living with an advanced, life limiting illness or for those people caring for them. You can call the support line for practical or clinical information, emotional support or following a bereavement.

Telephone: 0800 090 2309

Opening hours: Monday to Friday, 8:00am to 6:00pm, and Saturdays from 11:00am to 5:00pm.

NI Hospice at Home Nursing Service

The Hospice at Home Service provides nursing care at home for you as well as practical and emotional support and respite for your family and carers. It allows your carers to have a break, either during the day and early evenings, or if necessary, at night.

Your district nurse can refer you to this service.

Macmillan Buddy Service

This is a volunteer-led service providing practical and emotional support to adults affected by cancer. These trained volunteers can make a huge difference by providing help tailored to individual needs. Support can include light housework or gardening, walking the dog, shopping or running errands, having a chat and signposting to other relevant services.

Volunteers will not be able to help with personal care.

For enquiries about availability in your area, or to make a service request for yourself or someone you know affected by cancer, contact:

Email: VSScotNIR@macmillan.org.uk

Read more about support from Macmillan Buddies.

Specialist Palliative Care Services

On occasions some people with an advanced life limiting illness and complex symptoms require help from the specialist palliative care teams. This service is available to people in their own homes, care homes or hospitals and works alongside the general doctors, nurses and other team members.

Northern Ireland Hospice Community Service

In the community, specialist palliative care is provided by the Northern Ireland Hospice. Specialist nurses with advanced qualifications and experience in palliative care work across local areas providing care throughout patient clinics or visiting you in your own home. They complement the care provided by the GP and district nurse, by providing specialist advice and support to try to enable you to remain in your preferred place of care, whilst supporting your family.

Your GP or district nurse can refer you to this service.

Macmillan Specialist Palliative Care Team

In the hospital setting. specialist palliative care is provided by a team of Macmillan nurses and doctors who have advanced qualifications and experience in symptom management within palliative care. They can provide support, information and advice to you and your family. They can also provide support to your medical and nursing teams, should your needs become more complex whilst in hospital.

Specialist palliative care includes assessment and management of physical, emotional, social and spiritual issues. They also liaise closely with other staff in the hospital and community to ensure that the appropriate services are in place for discharge.

Ward staff can refer you to this specialist service.

Palliative medicine consultant

Palliative medicine consultants are senior doctors with specialist training in palliative medicine, including symptom control and end-of-life care. They are an essential part of both community and hospital specialist palliative care teams.

These doctors meet regularly with the specialist palliative care teams to discuss and advise on your care. If you have complex needs, they can make arrangements to visit you in hospital or at home. If appropriate, you can also be seen as an outpatient.

Your GP or hospice nurse can refer you to this service.

Specialist inpatient units

Specialist inpatient units provide a range of care for adults with complex specialist palliative care needs. They focus on enhancing quality of life and offering support for all areas of your life affected by your illness.

There are two specialist inpatient units available to people who live in the Northern Trust area:

Macmillan Unit, Antrim Area Hospital
Northern Ireland Hospice, Belfast

A specialist team of different healthcare professionals work together to provide care that supports all your needs.

In addition to medical and nursing support, this team includes a social worker, physiotherapist, occupational therapist, dietitian, chaplain and pharmacist.

Volunteers provide a valuable range of activities to complement the work and purpose of the specialist service.

Your specialist nurse or doctor in charge can refer you to a specialist unit.