Referral

All Dorothy House (DH) services are available free of charge within the catchment area.

A referral form must be completed for all referrals including essential information, clinical history and the aims of referral. Additional information may be requested from the referrer by the accepting Health or Social Care professional/Clinical Secretary.

Core referral criteria to Dorothy House:

Patients (aged 18 years or over) with a life-threatening illness who have complex or difficult physical, psychological, social and/or spiritual needs requiring our specialist expertise.

Relatives, families and/or carers of these patients who have related complex needs themselves and require additional specialist support, preferably with the knowledge of the patient.

Terminal care.

The person being referred is in agreement with the referral.

The GP is aware of the referral of the patient.

Scope of services offered

The Medical Team are available to give advice about any palliative care issues regardless of whether the patient is known to DH.

Patients referred for medical consultation can be seen at DH, in hospital or in the community setting i.e. home, care homes, community hospitals.

In-Patient Unit (IPU)

Specialist multidisciplinary team (MDT) assessment, treatment and management of complex symptoms/issues.

Respite care – planned (1 week) or acute.

Rehabilitation/adaptation to the effects of disease progression.

Terminal care (preferably for the last 1-2 weeks of life).

Nurse Specialists

Support patients, families and carers in all community settings through initial assessment, education and ongoing management of complex needs until discharge or death. They also:

Offer advice, information and support to professionals whether there is direct contact with the patient or not.
Assess the initial bereavement needs after death of DH patient in collaboration with the bereavement team.

Chaplaincy

The Chaplain is available to explore spiritual, religious and emotional needs with patients, families and carers.

Those referred can be seen at DH or in a community setting.

The Chaplain will link closely with local clergy as appropriate.

Day Patient Unit (DPU)

Patients can attend the nurse-led DPU for achievement of planned goals. Attendance is the same day each week for:

Specialist MDT assessment and management of complex issues
Rehabilitation/adaptation to the effects of disease progression
Opportunity to exchange emotional / practical / spiritual support with others facing similar challenges
Respite

There is also a fortnightly Support Group. This is for patients who do not require full MDT support for:

Peer support
Opportunity to exchange emotional / practical / spiritual support with others facing similar challenges

If required, transport for both services can be provided by volunteer drivers.
The service offers occasional open days that can be attended by the patient and a carer to give an opportunity for carers and patients to exchange thoughts and ideas.
There are no facilities to routinely hoist patients.

Complementary Therapy

Complementary therapies are, as the name suggests, treatments or therapies that may complement conventional treatment. The following treatments (up to four sessions of any therapy) are available for patients, families, carers and bereaved clients:

Aromatherapy
Reflexology
Relaxation
Reiki Indian Head massage (for carers only)

Creative Therapies

Creative Therapies are on offer to patients attending DPU and the IPU and provide an opportunity to explore existing or new interests when adapting and readjusting to the effects of disease progression.

There is a life stories project which provides the opportunity for DH patients to create a record of their lives/memories . This is available through the Creative Therapies Coordinator and delivered by a team of trained volunteers.

Physiotherapy Service

Specialist Palliative Care Physiotherapists are able to assess, treat and support patients across all settings. This includes:

Non pharmacological symptom control to address breathlessness, fatigue and pain
Palliative rehabilitation and adaptation to changes in physical condition or ability
We also support families and carers with relaxation sessions

Occupational Therapy Services (OT)

A Specialist Palliative Care Occupational Therapist is able to assess, treat and support patients across all settings. This service can address any problems that patients with palliative care needs are experiencing that impact on their independence, safety and quality of life.

Common assessments/interventions are:

Functional assessment
Assessment within home environment
Assessment for equipment and adaptation
Setting priorities and promoting independence and choice
Fatigue management
Wheelchair assessment
Palliative rehabilitation

Lymphoedema Service

This nurse-led service manages patients with predominantly cancer-related lymphoedema at local clinics, DH and all community settings.

Hospice at Home Service

This service provides nursing care by trained Health Care Assistants to support patients and their families in the community setting.

Where expected prognosis is less than 3 months, 1 or 2 night’s care can be provided per week.
Day care is also available.
Where prognosis is limited to 14 days, additional care can be offered. This is in conjunction with other services.
Short-term emergency care can be provided if unable to be met by another agency (priority will be given according to need).
If patients are not known to DH, a H@H Co-ordinator may do a home assessment.
Provision of care will be regularly reviewed.
Additional respite care is provided for DH patients to enable their carers to have a break for up to a week.
Care is provided in conjunction with currently established care arrangements.
Requests for respite must have a minimum of 2 weeks notice.
A H@H Co-ordinator will carry out a home assessment prior to provision of care where a more complex respite package is required

Adult Social Work

The Specialist Social Workers work with patients, families and carers to provide practical and emotional support, advice and information.

Childrens and Young People's Service

Family work; 1:1 work; couple work
Facilitation of family/professional meetings
Consultancy and signposting
Future care planning and review
Carers self assessment

Bereavement Service

This service supports children and young people up to the age of 18 years old.
It aims to offer direct support to individuals and families as well as guidance and advice to other professionals.
Available pre and post bereavement
Referrals can be made by members of the MDT at DH, professionals in the community or self-referrals from families of DH patients

This service offers a range of support services that are available to adult bereaved relatives and carers who have a direct connection with a patient cared for by DH, another UK Hospice or the RUH Palliative Care Team.
Referrals will be accepted from the bereaved client(s) themselves or via family, friends, DH or other professional carer if the client(s) has given informed consent.
Services are normally provided for a contracted period and clients may be seen at DH or in their own homes