Why hospice care should start sooner
People often think hospice care is only for the last days of life. Consultant in Palliative Medicine Dr Soumen Saha explains why earlier specialist support can transform quality of life, and how a growing partnership between ellenor and Darent Valley Hospital is helping patients experience more joined-up care.
Ask ellenor’s Consultant in Palliative Medicine Dr Soumen Saha what the biggest misconception about hospice care is and he doesn’t hesitate.
For him, one misunderstanding lies behind many of the challenges patients and families face.
Too many people believe hospice care only begins when treatment has ended and there is nothing left to do.
“People often think hospice care is only for the very end of life,” he says. “It really isn’t.”
“Our role is to support people living with complex, life-limiting illnesses, often much earlier than people realise. We’re here to help manage pain and symptoms, provide emotional support and improve quality of life while people continue living as fully as possible.”
Dr Saha explains that while palliative care and end-of-life care are often spoken about together, they are not the same.
“Our role is to become involved with people in the last year or so of life who have complexities like poor symptom control, psychological crises or other issues that can’t be managed by generalist teams. End-of-life care is part of palliative care, but palliative care is much broader than that.”
Importantly, not everyone referred to ellenor has cancer. Many people with other progressive illnesses can also benefit from specialist palliative care.
“Many of our patients have lung disease, kidney disease, liver disease, Parkinson’s, motor neurone disease or heart failure. People don’t always realise these conditions can be progressive and life-limiting. They don’t just affect how long someone lives – they can have a huge impact on their quality of life too.”
For Dr Saha, hospice care isn’t about replacing hospital care. It’s about working alongside it.
“We work alongside hospital teams, not instead of them,” he says. “People can still be receiving chemotherapy, seeing specialists and having treatment in hospital while also receiving support from us. It’s not one or the other.”
That philosophy is now being strengthened through a growing collaboration between ellenor and the specialist palliative care team at Darent Valley Hospital.
Although many people picture hospices as buildings with inpatient wards, around 90% of ellenor’s care is delivered in people’s own homes. Patients frequently move between home, hospital and the hospice during their illness, making good communication between professionals essential. The closer partnership helps ensure information follows the patient wherever they are receiving care, so every professional involved has the information they need at the right time.
That joined-up approach is already making a difference.
Earlier that morning, Dr Saha had been discussing the care of man living with advanced cancer who had recently returned to ellenor following treatment at Darent Valley Hospital.
Because of the close relationship between both teams, Dr Saha already understood exactly what had happened during the admission.
“We’d spoken directly with our colleagues at the hospital. We knew what medication had been changed, what had worked well, what hadn’t and what the plan needed to be when he came back to us.
“It’s almost as though we were there doing the ward round with them.”
For patients and families, much of that work happens behind the scenes. Whatthey experience is seamless care.
“When patients move between hospital and the hospice, every detail matters,” says Dr Saha. “Sometimes changing just one medication for pain or sickness can make the whole thing topple like a game of Jenga.”
“By talking directly with one another, rather than relying solely on written discharge summaries, we’re able to make sure important information isn’t lost.”
The benefits extend far beyond patients staying on the inpatient ward.
Many people receiving care from ellenor live at home and may need hospital treatment during their illness. Through the closer partnership, clinicians can quickly share important information before patients return home, ensuring community teams understand exactly what happened during a hospital admission and can continue care without unnecessary delays or gaps in communication.
The result is better continuity of care, greater confidence for clinicians and, most importantly, a smoother experience for patients and families.
But perhaps the greatest opportunity, Dr Saha believes, is helping people benefit from specialist palliative care sooner.
“One of the biggest challenges is that people often think being referred to a hospice means you’ve reached the end of the road. That’s just not true.
“If we become involved earlier, we have more opportunity to help people manage symptoms, support difficult conversations and improve their quality of life. It’s about living as well as possible for as long as possible.”
He also hopes closer working between hospital and hospice teams will continue challenging misconceptions within healthcare itself.
“Many doctors who haven’t worked in palliative care understandably don’t always know when specialist support should be involved. That’s changing through education and through relationships like the one we’ve built with Darent Valley Hospital.
“The more we understand each other’s roles, the better we can support patients together.”
The collaboration is also creating opportunities for shared learning between clinicians, ensuring specialist knowledge is shared across organisations and ultimately benefiting future patients.
For Dr Saha, the partnership isn’t just about improving communication between professionals. It’s about ensuring people receive specialist support at the right time, before symptoms become overwhelming.
“We should be involved when people are still mobile, still getting around, still able to have conversations with us. If someone has a progressive illness and you can see that complexity is coming, that’s the time to refer them.”
Ultimately, he says, success isn’t measured by meetings or new ways of working.
It’s measured by what patients experience.
“Ultimately, it’s about sharing knowledge, improving communication and giving people the best possible experience during one of the most difficult times in their lives.
“We want people to receive the right care, at the right time, from professionals who are talking to one another.
“Whether someone is being cared for at home, in hospital or here at the hospice, our aim is the same. When we’re working together, patients spend less time worrying about the system and more time focusing on what matters most to them.”
For anyone living with a life-limiting illness, hospice care isn’t about giving up hope. It’s about getting the right support at the right time, so you can live as well as possible for as long as possible.
