Practical help

During your illness, the support that you need is likely to vary. You might be cared for at home, in hospital or in a hospice or care home.

If you’re at home, your GP has overall responsibility for your care. You might be offered help from nurses who can visit you at home. This might be a community nurse or palliative care nurse. Nurses can give practical help, advice on symptom control and emotional support. You may get other help from carers, physiotherapists, occupational therapists, psychologists or social services. Talk to your GP to find out what’s available in your area.

If you have troublesome symptoms, your GP may refer you to a hospice or a palliative care unit in a hospital. Some people go into a hospice for a short stay to help control their symptoms. Hospices also offer support such as counselling and psychological support. Many hospices have day centres that people can visit once or twice a week if they wish.

Some people will have care in a care home. Some of these are residential and some offer nursing care.

Who can help?

There may be times when you need a lot of help and support from doctors, nurses and other carers. For example, you may need extra support if you are having treatments like chemotherapy, or if you have symptoms that are worrying you. But at other times you may need very little help from your healthcare team, and you might only see them for check-ups.

If you’re having treatment such as chemotherapy, targeted (biological) therapy, hormonal therapy or radiotherapy, you will be looked after by a cancer doctor. You will usually go to the hospital regularly for check-ups.

If you are no longer having treatment to control the cancer, you might be referred to a palliative care team. These are specialists who help you to manage symptoms such as pain. They are usually based in hospitals and hospices.


Home care

There is help and support for people being looked after at home, and also for their carers. It is not possible to get 24-hour nursing care at home and the amount of support available varies across the UK. Your GP or social worker can advise you on what is available in your area.

We have more helpful information on the support available to the people caring for you.

Below we have listed the people who are most likely to be involved in your care when your cancer is advanced.

GP (general practitioner)

When you are being looked after at home, your GP has overall responsibility for your care. Your GP is also responsible for prescribing any drugs you need, and for arranging admission to a hospital or hospice if necessary. Along with the support of other community professionals, such as community or palliative care nurses, they will assess your nursing and medical care needs, and arrange the necessary help. Once home care arrangements have been set up, you will probably see the community nurse more regularly than your GP.

Nurses

  • Community or district nurses can make regular home visits. They offer nursing care services, which may include changing dressings, giving medicines and supporting carers. They can also arrange practical aids, such as pressure-relieving mattresses or commodes.
  • Palliative care or symptom control nurses are sometimes known as Macmillan nurses. They specialise in managing pain and symptoms. They are also specialists in giving emotional support to patients and their families. They may be based in hospitals or hospices, or they might visit people in their own homes. They don’t usually provide daily nursing care, but they can call or visit you regularly to check on your symptoms and support you. For example, they can advise you about which medicines to take if pain is a problem. They may also be able to give you information about certain financial benefits you can apply for. Palliative care nursing services are free. Your GP or your doctor or nurse at the hospital can arrange a palliative care nurse for you.
  • Marie Curie nurses are available in some parts of the UK. You can get one-to-one overnight nursing from a registered nurse or senior healthcare assistant in your home. The shifts are usually for eight or nine hours. In some parts of the UK, they also offer shorter shifts, evening shifts and day shifts. How much care they will be able to provide may differ. They will not usually be able to offer complete 24-hour cover. The services of Marie Curie are free. They are usually arranged through the district nurse, who will talk to you and your carers to decide what hours of care you need.

Home care teams

These are usually based at a hospital or hospice, but they work with people at home. The teams usually include specialist nurses, who have had training in symptom control and emotional support. These are often palliative care nurses. Sometimes the team includes a doctor, who may share your care with your GP.

Other professionals

  • Clinical or counselling psychologists are often part of the hospital cancer (oncology) services or the palliative care team. They are specialists in providing psychological and emotional support to people with advanced cancer. For example, they can help if symptoms of anxiety or depression become overwhelming, and with any relationship problems. Some psychological services will also offer support to carers and family members.
  • Occupational therapists working in the community can help you keep your independence at home. After an assessment, they may be able to arrange for aids to be delivered, such as toilet frames, handrails or a wheelchair. They can also arrange for changes to be made to your home, such as fixing safety rails in bathrooms or making doors wider. If you have difficulty dressing, they may be able to suggest and arrange to have your clothes altered. Many occupational therapists may also be able to help you manage low moods, by changing daily routines and activities. Some therapists also get involved in managing anxiety.
  • Physiotherapists can help keep you moving. They also offer treatment, massage and exercise programmes to help relieve pain. Your GP or community nurse can put you in touch with a physiotherapist.

Social services

Your hospital team, GP or district nurse can refer you to social services. Or you can refer yourself.

You are usually offered an assessment of your needs. A social worker, or sometimes an occupational therapist or nurse, will ask you questions about your daily routine and what you find difficult. They use this assessment to work out what your needs are and what support can be provided.

You usually have to pay towards the cost of services depending on your financial situation. But you may be entitled to extra benefits to help you get care.

Each local authority will have its own assessment procedure and information on their website.

Local authorities will also provide an up-to-date list of local providers and can signpost you to services.

The website socialcareinfo.net can also direct you to your local authority website and other sources of local support.

Care attendants or carers can come into your home to help with jobs around the house, such as cleaning and cooking. They can also help with some personal tasks, such as washing and dressing. Some care attendant schemes provide someone to be there at night.

This type of help can be arranged through private agencies, which must be registered with the Care Quality Commission. The UK Homecare Association can give you details of home care providers that follow its code of practice – call 020 8661 8188. Your local adult social services department should be able to provide you with details of approved private agencies. You can also ask friends or relatives for recommendations.

Charities such as Age UK and Carers Trust can also provide home help and extra help around the house.

Other sources of help at home

  • British Red Cross has volunteers that can help you with shopping and errands, like posting letters and changing library books. It also lends equipment, such as wheelchairs and commodes, and provides a service to take people to hospital.
  • Lots of areas have volunteer schemes that can arrange for someone to visit your home, to provide company for you and give your carer a break. You can contact your local Community Volunteer Service or the Volunteer Bureau to find out what’s available in your area. You could also check notice boards in your GP’s surgery or your local library, community centre or church.
  • For people needing a lot of health care or who are in the last few weeks of life, NHS Continuing Healthcare may fund and provide for all your care needs at home. This includes personal care from health care assistants.


Hospice care and care homes

If you have worrying symptoms, you may need extra support. Your doctor or nurse may refer you to a hospice or palliative care (symptom control) unit in a hospital.

Hospices

Hospices specialise in caring for people who have a life-limiting illness and may be approaching the end of their life.

They have doctors and specialist palliative care nurses who are experts in controlling symptoms, such as pain, and providing emotional support. They also have staff nurses or healthcare assistants who can visit and help care for people at home. Some have day centres for people living at home.

You can go into a hospice for a short time to have your symptoms controlled. In some hospices, you can go in for a period of respite care to give your carer a break. You may decide that you would like to die in a hospice. If so, you will need to discuss your wishes with your GP and the hospice team involved with your care.

Hospices offer a wide range of services for patients and their families. These include:

  • counselling
  • spiritual care
  • complementary therapies
  • psychological support
  • bereavement support.

Accommodation and care in a hospice is always free of charge. There are a limited number of beds in each hospice and there will usually be a waiting list.

Some hospices run daycentres for people who do not need to be an inpatient, but who would benefit from spending a day or more each week at the hospice. They can get care from the specialist team and peer support from people living with illnesses similar to theirs.

You can find out more about your local hospice from your GP, district nurse or palliative care nurse. Hospice UK also has useful information about hospices and where they are located across the UK. If you are not sure about the idea of hospice care, you can ask to visit the hospice before making a decision. The staff will be able to show you around and chat through any questions or concerns you have.

Care homes

You or your family may think you would benefit by staying in a care home. Your GP, district nurse or social worker can arrange for you to stay in a residential care home, either with or without nursing care. They may offer short-stay or respite care, but usually also offer long-stay care. For someone with an advanced cancer it is important to consider future care needs. You may not have any nursing needs now. But thinking ahead can prevent moving into a residential home, and then needing to move again to somewhere that offers nursing care.

A residential care home provides living accommodation, meals and help with personal care. If you need nursing care some registered care homes can provide this. These are often referred to as nursing homes.

Private nursing homes and residential homes charge a fee. You may be able to get free care if you are eligible, following an assessment by a social worker or care manager.

Availability of care varies from area to area and can take a while to organise.

The details of registered residential care homes are available from your local social services department and your area health authority. You can get information about finding a residential care and nursing homes on the NHS Choices website.


Help with pets

If you have a pet and are concerned about them while you are in hospital or having treatment, there are organisations that offer services such as dog walking. If you need to be away from your home for a while, some organisations may be able to foster your pet.

Back to Coping with advanced cancer

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Making CPR decisions

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