End of life care: What my job means to me

2 Aug 2016 Amyholgate

Angie Carpenter, Healthcare Assistant, Palliative Care Home Support

Some patients don’t want to talk about dying with me. Sometimes they do. I tell them to take each day as it comes, but I just can’t imagine what they are going through.

Sometimes families are relieved to leave us to it, and some like to be involved, or sit in the room while we do it. We are really guided by them and respond to their cues.

I try and break down barriers. Rugby is always a good one – I’m a massive Wales fan. I show my patients pictures of me watching a game with a sheep or a daffodil on my head. Just finding an area of interest for them can help.

Some patients are very reserved, and take a while to accept strangers. When you are giving them personal care, it can be very difficult for them. It’s very intimate. You have to take it gently, gently – and with the family too. You don’t want to take over. You need to build trust.

I always say: “I promise, in a couple of weeks’ time, you’ll be looking forward to us coming.” And 100% of the time, they do.

It can’t be all gloom and doom. Laughter really is a good medicine. I try and focus on everyday life, on something other than the illness.

Most days I cover 100 miles. In my team most of us cover nearly 10,000 miles a year. We’re dedicated to the job.

Working with patients experiencing dementia is very hard. Often I will ask them “Are you in pain?” and they’ll say “no”. But how do I really know?

I never switch off. I think about patients on my day off – it’s the same with all of us. It’s a vocation. When patients pass, it often feels like a happy release for the patient. But it’s so sad for the families.

Sometimes it can be a relief when death comes, because it can be a waiting game which lasts for days. Marie Curie provide ‘nightsits’, where they sit with patients overnight to give relatives a break. And Hospice at Home provides temporary care for 24 hours too. It depends what the family needs.

Afterwards we support the family in any way we can. Sometimes we have to wait for the GP to verify death if the nurse isn’t registered to do it. Then the undertakers will come to take the body, but sometimes relatives want a bit longer with them. It’s a very personal thing.

Dogs very often pick up signals about death approaching. I’ll always remember one of them. The patient owned a husky, who never really moved or even blinked when we came in for a visit. But one day, he was in and out, up and down – really restless. And then he licked her face, and she was gone.

They call us angels. We do everything we can to make patients more comfortable. We only have one chance to get it right.

Our Palliative Care Home Support Team

The Bristol Community Health Palliative Care Home Support Service works with other healthcare professionals to offer personal care and emotional support when patients are reaching the end of their life – find out more about the service here. Referrals to the service can be made only by health or social care professionals for patients registered with a Bristol or South Gloucestershire GP.

Angie Carpenter palliative care
Angie Carpenter, Healthcare Assistant