Msunduzi Hospice: What exactly do we do?

I have worked in the care team at Msunduzi Hospice for roughly ten years now and over this time have often been asked, “What does hospice do?”

After ten years I find it difficult to answer that question comprehensively; to be quite honest, I only fully figured out what it is that we really do after a year or two at Hospice. To start off with I thought we simply drove around visiting people, giving advice, chatting a sometimes-drinking tea. It was the best job I ever had.

Ten years ago, I would have told you that we visit people with illnesses like cancer and try to help them and their families. Now when I am asked what Hospice does my more professional and polished ‘in a nutshell response’ is that we provide palliative care to people facing life threatening illnesses. This does not begin to explain it, though, and I often find myself elaborating on the services that Hospice provides to explain how we deliver this palliative care. So here, as briefly as I can manage it, are the basic services that the care team provides:

Clinical support: We have a team of nurses who visit roughly once a week (depending on need). In the Edendale are we also have caregivers who assist the nurses with visiting patients.

Clinical Support includes:

Giving advice on any medical issues, e.g.: pain and symptom management, what to expect from treatment, the illness and its progression.
Offering advice and education on how to provide physical care of the ill person, wound care, infection control etc.;
Loan of equipment such as wheelchairs, commodes, bath chairs (equipment loan is exclusively for our patients);
Preparing families for the death of a loved one by explaining what to expect and how to deal with this event and the time leading up to it. Included is what to do after a death has occurred;

Emotional support: as all people are different it is impossible to quantify or list how emotional support is offered but this a huge part of what the Hospice Care Team does. Nurses and Caregivers will offer emotional support at each visit, but we also have social workers who will do more in depth counselling when the need arises. Coming to terms with you own mortality, or that of a loved one, can be a difficult process and something we are very aware of. With palliative care we do not focus only on the patient but also look at supporting the family emotionally as well.
Social and spiritual care: Our social workers are often involved with these aspects of care. They, among other things, offer advice on how to access grants and pensions, look at finding placement when this is needed, offer family counselling and try to facilitate the cooperation of family members in the care of the patient. When there is a need for spiritual care we may need to refer to external resources, but the basics of spiritual care is also offered;

Another important aspect of social care is caring for the children of patients. The social workers assist with counselling, but we also offer memory work for the children. Our two memory workers help children to deal with the difficult situation they find themselves in when a parent or caregiver is ill. A huge part of their work is also emotional support for these children; under the supervision of a social worker, they also run children’s groups and healing sessions.

Bereavement care: This is offered to family members for a period after the death of a loved one. The care team will periodically contact family members to see how they are coping. More in depth bereavement care is available if needed and is headed up by one of our social workers.

There are some limitations to what services Hospice can offer and this often comes down to the availability of resources and ensuring that we distribute resources equally among our patients. We have strict admission criteria and cannot travel too far out of town. We also cannot provide transport for patients, we cannot provide scripts or treatment and we do not have the staff to offer daily care for patients. However, despite these limitations, the care team really does try and meet the need of patients and their families and the list of services we offer can fall short of explaining what it is we do.

I can’t remember exactly when it started dawning on me that those cups of tea and the chats about this and that are more than they seem to be. They are the first step to forging a relationship to be able to do what it is that we aim to do. What we really do (or try to do) is come alongside people at a time when their lives are upside down and try and give them some guidance and direction so that they can start to turn their lives right way up again. I think, perhaps, a better “in a nutshell” description of what Hospice does is that we quietly walk alongside families who are facing life threatening illness and provide support and care to enable them to cope with the challenges that such illness brings.

Training: In 2017 we had some exciting developments with training. Various Hospices have been asked to do training in palliative care for the Department of Health. Apart from the funding given for this, this is a wonderful opportunity to get the word out about palliative are. We look forward to sharing what we know about palliative care with health care professionals from a variety of facilities. Every journey starts with a first step and we hope that this journey will continue until palliative care is available to all who need it in South Africa.

Our community trainer has also been very busy with requests for our 5 days, non-accredited, Home Based Care training for community members. We hope that this will continue in 2018. Any queries can be addressed to Winnie Gasa, our community trainer.

This year we have decided not to schedule any of our usual workshops and courses as we have had poor responses and have had to cancel most of our training last year. However, we will run the workshop/course on request for a minimum of 10 people. Any queries can be addressed to Heidi Collyer.

The courses/workshops available are as follows: