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‘It is not about death and dying, it is all about living’

Director of Nursing Yvonne Martin explains the Foyle Hospice offers a range of services

‘It is not about death and dying, it is all about living’

Director of Nursing, Yvonne Martin

In any one week, the Foyle Hospice cares for over 200 patients, at home, in the Day Hospice Centre and in the hospice's Inpatient Unit.
The Home Care service was the first service that Foyle Hospice offered before the Inpatients Unit opened on its Culmore Road site in 1991.
The Home Care service has been offered to patients in Derry and the North West since the mid-1980s.
From the very outset of the Homecare Team provided services into Donegal to include Inishowen and Letterkenny. There was a Foyle Hospice Specialist Nurse based in Letterkenny Hospital appointed in 1989.
The Community Team consists of six nurses who cover from Derry City out to Sion Mills, Limavady, Claudy and Dungiven and work in two teams of three.
 
Inpatient unit
The hospice Inpatient unit is a nine-bed unit which offers specialist palliative care for patients with life-limiting conditions which include cancer, motor neurone disease, PSP, and illness of the liver, lung and kidney.
The nine-bed unit has communal areas and relatives’ rooms as well as two apartments for relatives.
The specialist unit also treats complex patients who may be difficult to manage and they come into the hospice for a period of time until their symptoms are under control and they can go home again.
The Inpatient Unit also gives patients end of life health care. Out of the admissions to the unit, every year up to 55% die there and the rest go home to be managed by the Hospice Community Team, Director of Nursing Yvonne Martin says.  
The Day Hospice opened in 2002 and offers services three days a week, including an integrated care clinic where patients can see a doctor. Twelve patients a day attend the Day Hospice.
“All our patients regardless of whether they are community patients and Day Hospice patients, their key worker in the community is their GP, so our teams work very closely with their GP and the primary care team and district nursing team. Our teams are invited in to offer advice support and symptom management,” Yvonne says.

Bereavement services
The hospice provides care for the Northern sector of the Western Social Care Trust but there is a range of other services that are also important parts of what the hospice offers.
Bereavement services are a big part of what the hospice does. Forget-Me-Not is an adult bereavement support group which runs a six-week program twice a year. The service is run by two hospice nurses for relatives of inpatients, day hospice or community patients.
“They work through six programmes of different stages of grief and give people advice on how they might manage their grief and how they might cope better with their grief and their loss and bereavement.
“For the community team, everybody from the service who has died, there is a time span they look at because obviously, they have to give people an adequate time to grieve normally because everyone has to go through the grieving process so you don't go to those sessions too soon after your bereavement.”
Foyle Hospice provides a limited volunteer-led counselling service and because it is so limited and provided by dedicated volunteers, sometimes the hospice has to signpost referrals to other sources, such as Cruse counselling service and Derry Well Women.

Healing Hearts
Healing Hearts is a service delivered to children and young people from the ages of 4 to 16.
“A  Children’s and Young Person’s Facilitator sees children pre-bereavement, post- bereavement and works with them and provides different activities for children who have lost a significant adult - it may not be a parent, a grandparent or a close uncle or a close aunt,” says Yvonne.
The Healing Hearts service is delivered in the hospice, at home, in schools and also provides support to children who have been bereaved through suicide, road traffic collisions and sudden death.
Another service the hospice provides is the 24-seven telephone advice service where any health professional, patient or relative can phone the hospice out of hours to get advice.
“They might just be finding things difficult at home and they might need a bit of reassurance that what they are doing is okay or they may need assurance that it is okay to ring GP out of hours or Western Urgent care and try to get someone out,” Yvonne says.
“That telephone advice can be quite invaluable to people out there in the community, so they know they can ring here.”
In the case of a more complex query, the call can be put through to an on-call doctor.
The service is available to anyone, whether they are a hospice patient or not.
“It is very useful because at the minute we don't have a seven-day service in the community and there is no consultant or special palliative care on call for the Western Trust,” says Yvonne.
“But it just comes down to funding and a lack of money to increase these services.”
The hospice has a permanent nursing staff of 50 with six in home care and five in the day hospice with the rest in the inpatient unit providing 24-seven care.

‘Challenging and rewarding’
Yvonne has worked in the hospice since it opened in 1991 and although work is challenging she finds it very rewarding.
“People will say 'I don't know how you work in the hospice, working with death and dying all the time,' but actually the patients that come in here and their families, we try to keep them very much upbeat and that’s what they like - some sort of normality in their care.
“They want to be treated as individuals, not just someone who may have a life-limiting illness depending on what stage they are on their journey. It is nice to have a bit of normality and a bit of laughing and joking.”
Some patients and relatives who may have had a reluctance about coming to the hospice because of the associations of death and dying change their mind once they experience it, Yvonne says.
“They say ‘I’m sorry I didn't come sooner,” because they realise it is not about death and dying. It is all about living and getting them in a better position both physically and psychologically and emotionally so they go back out and live in their own homes and live as normal a life as possible.”

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