End-of-life and palliative care

Facing a serious illness, whether your own or that of someone you love, is one of the hardest things any of us goes through, and it is natural to feel frightened, or unsure where to turn. Please know that there is a great deal of skilled and kind support available, and the aim of all of it is the same: to help you live as comfortably and as fully as possible, with dignity and choice, surrounded by the people who matter to you. This page explains what palliative and end-of-life care mean, the help available close to home, and how to make your wishes known.

What palliative care means

Palliative care is care for anyone living with a serious, life-limiting illness. It focuses on comfort and quality of life: easing pain and other symptoms, and offering emotional and spiritual support, both for you and for your family.

Importantly, it is not only for the very end. It can begin much earlier, and it can run alongside any treatment you are having. End-of-life care is the name given to palliative care in the last months, weeks and days of life. Throughout, the goal is the same, to help you live as well as you possibly can.

Where care can be given

Palliative care can be provided wherever you are, whether that is in your own home, in a care home, in hospital, or in a hospice. Many people would prefer to be cared for at home, or somewhere that feels homely, and with the right support in place that is very often possible. Your own wishes about where you are cared for are an important part of the plan.

Help close to home: Ashgate Hospice

For people across North Derbyshire, Ashgate Hospice in Chesterfield provides specialist palliative and end-of-life care, and all of it is free. While the hospice has an inpatient unit for those with the most complex needs, most of its care is given in people's own homes, by teams of specialist nurses and therapists who work hand in hand with your GP and district nurses to keep you comfortable.

The hospice also offers emotional, practical and spiritual support, day services, and a great deal of support for families, including bereavement support and a dedicated service for children. The usual way to be referred is through your GP or district nurse. Ashgate also has a Care Advice Line on 01246 565026, open 9am to 5pm seven days a week, if you would simply like to talk something through.

Your GP and community nurses

Your GP and the community, or district, nursing team are at the very heart of palliative care at home. They coordinate your care, help manage your symptoms, and arrange extra help, such as nursing through the night, when it is needed. Please do not hesitate to tell them how you are feeling, in body and in mind, because there is a great deal they can do.

Managing pain and other symptoms

One of the biggest worries people have is about being in pain. Please be reassured that pain and other symptoms can usually be managed very well indeed, and keeping you comfortable is the whole focus of the palliative care team. If something does not feel right, do say so, as your care can always be adjusted until it is.

Making your wishes known

Thinking ahead about the care you would, or would not, want can bring real peace of mind, both for you and for those close to you. You might choose to write down your wishes in an advance care plan, to record where you would prefer to be cared for, or to make an advance decision to refuse particular treatments. You can also set up a Lasting Power of Attorney, so that someone you trust can make decisions about your health if there comes a time when you cannot, and you can talk through a ReSPECT plan with your doctor for emergency situations. It is a good moment, too, to make sure you have an up-to-date will. Your GP or the hospice team can gently help you begin these conversations whenever you feel ready.

Help with money

There is financial help available as well, and it is well worth claiming. If a doctor believes someone may be in the last year of life, benefits such as Attendance Allowance can be fast-tracked, paid at the higher rate without the usual waiting period, and we have a separate guide on Attendance Allowance. The NHS may also fully fund someone's care through NHS Continuing Healthcare. A free benefits check can make sure nothing is missed, at a time when money worries should be the last thing on anyone's mind.

Support for family and carers

Caring for someone who is seriously ill is a great act of love, but it is also tiring, and your own wellbeing matters every bit as much. You are entitled to a carer's assessment in your own right, and both Ashgate Hospice and Derbyshire Carers Association offer support, advice and a friendly ear. For anyone affected by cancer, the Macmillan Support Line, on 0808 808 00 00, offers practical, emotional and financial help.

Someone to talk to

Alongside the medical care, emotional and spiritual support is always there for the asking, whatever you believe or do not believe. Hospices and hospitals have chaplains who will sit and talk with anyone, of any faith or none. The Samaritans are there at any hour, on 116 123. And if it would simply help to have some friendly company through a difficult time, that is something we at BrightLife are here for, through our befriending service.

After someone dies

When the time comes, support continues for those who are left behind. Ashgate Hospice offers bereavement support to families across North Derbyshire, and Cruse Bereavement Support has a free helpline on 0808 808 1677. We also have a separate guide on bereavement and the practical things that need to be done, for whenever you feel ready to look at it.

Where to get help, locally and nationally

Close to home, across Chesterfield, Bolsover and North East Derbyshire:

• Ashgate Hospice, for specialist palliative and end-of-life care, and for family and bereavement support. Its Care Advice Line is 01246 565026, open 9am to 5pm, seven days a week.
• Your GP and district nursing team, who coordinate care at home.
• Derbyshire Carers Association, for support if you are caring for someone.

Across the country:

• Marie Curie, on its free Support Line 0800 090 2309, for information and support at the end of life.
• The Macmillan Support Line, on 0808 808 00 00, for anyone affected by cancer.
• Cruse Bereavement Support, on 0808 808 1677.
• The Samaritans, on 116 123, at any time of day or night.
• Independent Age, on 0800 319 6789, for free advice and factsheets.