A guide to who’s who at St Christopher’s

It can sometimes be difficult to know who is responsible for what. The list that follows explains who’s who at St Christopher’s and in the community

Clinical nurse specialists (CNS or specialist palliative care nurses) are nurses who have had extra training in palliative care to give emotional support and practical advice to patients and their families and provide pain and symptom control. They do not usually provide hands-on care, but give advice to the primary healthcare team (see below) and link into the hospice or hospital. If your friend or relative is being cared for at home, then the St Christopher’s nurse who visits them is a clinical nurse specialist.

If the patient is living in a care home, the St Christopher’s specialist nurse will advise the care home staff on symptom control and good palliative care. She can also refer the patient to other St Christopher’s services.

The primary healthcare team usually includes the GP, district/community nurse, practice nurse, practice manager, receptionists, health visitors and other associated professionals.

The GP (general practitioner, or family doctor) is responsible for all aspects of medical care at home, and can arrange help from other professionals or services. St Christopher’s at Home nurses work closely with GP practices.

District nurses provide hands-on nursing care and practical advice in the home. In some boroughs district nurses are available 23 or 24 hours a day. They can usually be contacted through a GP’s surgery or directly at their office.

The St Christopher’s occupational therapist gives advice on and provides equipment to help make daily life easier, e.g. with bathing, stairs or lavatory.

The St Christopher’s physiotherapists help people maintain or improve their strength and mobility through exercises. They treat swollen limbs, help with pain relief, breathlessness and anxiety/panic attacks.

The St Christopher’s social workers specialise in helping people to cope with the emotional and practical stresses that serious illness can bring. They can help you think about concerns about the future, or with talking to other members of the family, including children, to understand, for example, the illness and the changes it has caused. St Christopher’s social workers can tell you about support groups for carers where you live.

Social workers employed specifically by social services undertake carers’ assessments, i.e. assessments of your needs as a carer. This should take account of your work and any other responsibilities you may have in order to support you and the person you are looking after. Ask your social services department to arrange for you to have a carer’s assessment.

St Christopher’s welfare officers can help with some of the financial and practical issues that may arise as a result of the illness. They can help with benefit claims, grant applications, housing problems, sorting out debts and other practical matters. They can advise on the need for legal advice (in making a will, or applying for power of attorney).

Caring for someone can be expensive. For example, you might have higher heating bills, extra travel costs, have to cut the hours you work, or leave your job altogether. There are many benefits that may be available to you or the person you care for, and it is important to get advice on these as soon as possible.

Care agencies employ carers who provide personal care such as dressing and washing, and domestic help for people in their own homes. Some social services departments also provide home care. There is a charge for these services and depending on your financial circumstances you/the patient may have to contribute to the costs.

In the last days of life services such as Marie Curie nurses, or the St Christopher’s Hospice at Home service, may be helpful. These services give carers a chance to catch up on sleep, or take a break. Talk to your St Christopher’s nurse if you would like to find out more.