Just three months after opening in 1994, Rowans Hospice started to provide therapeutic day care services to support local people in our community living with life-limiting and progressive illnesses. Tracy Jeffery, Manager of the Rowans Living WellCentre, provides an insight into why this has been, and remains, so valuable.
When living with a life-limiting illness, it’s really important to provide an opportunity for the person to maintain social interaction, whilst accessing specialist person-centred support. Support which helps them to improve their quality of life, removing the label of their diagnosis and restoring their name and true identity.
Originally Rowans Hospice offered traditional ‘day care’, which incorporated different activities, entertainment, complementary therapies and various types of arts & crafts.
The activities provided patients with opportunities to interact with others within an environment where they could naturally and safely share and talk about difficult subjects and possibly troubling thoughts.
Conversations ranged from ‘I don’t know how to tell my family this’ to ‘I am dying, I know I am dying but actually I don’t know how to tell my granddaughter. Then someone would share ‘you know what I did at the weekend, I have sorted out my funeral’ or ‘actually I found these shoes helpful’.
Conversations were frequently entwined with laughter, explained Tracy, recalling many hilarious chats where at times the humour was also very dark! These moments of sharing have been important to maintain whilst developing the service.
Facilitating important conversations
When people visit the Living Well Centre, they are gently encouraged to talk about ‘those difficult’ conversations, which they may be struggling to have. But it’s important to enable people to manage their preferences and choices – such as talking about resuscitation and advance care planning for the future, in a sensitive manner.
Staff and volunteers have the experience to support and facilitate these conversations and, although extremely hard, people do welcome this opportunity.
Friendship and respite
The relaxed environment, beautiful surroundings and gentle therapies on offer are seen by Tracy as key components that have led to the success of the centre. In addition patients quickly talk openly to each other and start to form lovely friendships, often meeting outside of the hospice too.
This is also true for carers and spouses, who develop friendships and support, which is maintained into bereavement. Plus the centre offers them respite as they know their loved ones will be safe and well-cared for, especially if they have nursing care needs.
As carer Wendy Groombridge said: ‘I knew I could leave dad in a place where he was safe, supported and cared for… I didn’t have to worry about him.’
Since our therapeutic day care services first started 25 years ago, we have built upon what is really valued - friendship, companionship, the need to be treated as a unique person - and incorporated these values into the Living Well Centre.
The centre’s primary purpose is to enable people to live well, supported by a therapeutic team of health professionals, complementary therapists and trained volunteers who offer guidance and support.
Tracy explained that a range of patients visit the centre, from those who have just been diagnosed to those whose illness is more advanced and require more care. For those who are newly-diagnosed there is often a need to have information and in this respect they often link people with other services provided by the NHS, Adult Social Care and other charities and community groups, as well as designing a timetable of activities to help them to live well and maintain quality of life.
For those with nursing needs, the care team will undertake an initial assessment to establish if they are able to meet their needs. Following this they can attend the centre for part of a day or a full day, following an agreed programme of care which is co-designed. This care plan often includes referrals to other team members such as physiotherapist, psychologist or chaplain.
Meeting their needs, not ours
Tracy concluded: ‘It’s inspiring working here, as Rowans’ services are so innovative. The patient, carers and the bereaved are always at the forefront of everyone’s thoughts. Services are developed to meet their unique needs and not just what ‘we’ believe is best for them.
We are motivated to improve the quality of life for all the visitors and to continue to strive, adapt and improve our care services into the future. The Silver Jubilee Appeal is a really clear example of this, as the hospice refurbishment will enable us to continue to meet the growing and changing needs of our community.’
Susan Meager talks about her experience of attending regular therapeutic day care sessions at the Rowans
‘I was referred to the Rowans by my GP as things had got hard and I was struggling emotionally and physically. My breast cancer had come back and this time it was terminal.
‘Pre-existing healthcare complications felt like they were becoming unsurmountable, compounded by a stroke which meant I was becoming increasingly confined to my own home.
‘I wasn’t at all keen to go, but saying yes was the best thing I have done and I only wish I had known about the Rowans Hospice sooner.
‘I was very doubtful when I arrived, but that soon went away. I can’t say enough good things about the nurses and all the staff. They are just amazing. Plus the weekly sessions have provided me with a group of new friends who are in the same boat.
‘We all look out for each other, sharing our anxieties, fears and also our laughter. The friendship, laughter and the mix of activities available each day, especially the craft activities which I have always loved doing, have helped me to gain a new perspective about my situation and to embrace every opportunity to do the things I love.
‘Rowans has also given me so much practical help dealing with sorting out my accommodation and getting me the correct equipment. Plus the food is delicious!
‘The love and support I have gained from attending Rowans, means that I am in a much better place than I was when I first came through the door.
‘It has given me a new lease of life. All in all, it is due to the wonderful staff at the Rowans that I have realised that my life is worth living. I now know that whatever time I have left, I want to make sure I Iive it!’