Frequently Asked Questions

What is Cotswold Care?
The Hospice offers support to people with a potentially life-limiting diagnosis. Our care extends to family and carers of individuals directly affected by the consequences of the illness. Although the building will always remain central to our service delivery we are also committed to expanding our services within the community. We reach out to our community to support patients, carers and families during different times in their illness journey and can enable patients to die in their own homes should they choose to do so.

What does Hospice/palliative care mean?
Hospices are no longer used just for the last days of life. They offer a wide range of support, often alongside active treatment for an illness. The focus of modern hospice care is on helping people live well until they die-this may be by helping with emotional, physical, spiritual or social distress but at all times hospices/palliative care services are guided by principles of respect, choice, flexibilty and dignity. This type of care is generally for people whose illness is no longer curable; the disease may be at a more advanced and progressive stage. It aims to work with patients to help them achieve the best possible quality of life during their illness. Hospice care also reaches out to families and friends by supporting them through the patient’s illness and into bereavement. It treats each person as an individual and adopts a holistic approach taking into account all that is important to that person.

Is Cotswold Care a place where people only go to die?
No, the whole ethos of Palliative Care/Hospice care is to provide an environment and/or culture in which people can live their lives to the full within the constraints of their illness. Our philosophy of care is based on the promotion and maintenance of quality of life for each individual and their carers, enabling them to remain at home as long as they wish. Care can be aimed at helping patients adjust to their changing situation following diagnosis; for a small number of patients this may be end-of-life care, helping them to live as full a life as possible in the very final stages of their illness.

Do you have beds at Cotswold Care?
No, we don't have an in-patient unit at this time. All our services are community based. Most people when asked prefer to die in their own home although certainly not all.Our Hospice-at-Home service was set up to assist patients to die in their own home should this be their choice and to support other teams such as nursing home staff to support a patient in their usual care or residential setting.

Do I have to have cancer?
No, people don’t have to have cancer to be referred to the Hospice; any person with palliative care needs following the diagnosis of a life-shortening illness can be referred. People with chronic lung disease, end stage renal disease, neurological conditions and heart failure have all been able to benefit from our services.

Does your Hospice care mainly for older people?
No, we care for any adult aged over 18 years. We have tried to make our services as flexible as possible to help those individuals who may be supporting young families and/or still working whilst receiving treatment. This means that adults of all ages can benefit from our wide range of services by accessing services such as counselling or life affirming therapies on an out-patient basis.

Do my district nurse and GP provide palliative care?
Yes, all health care professionals provide the principles of this type of care. They have many skills and expertise in palliative care. The Hospice works closely with these and other health and social care professionals involved in the patients care.

Why is a referral to the Hospice needed for some people?
Sometimes problems can become quite complex; in most cases the GP, district nurse or social worker etc can help with these but for some people it can be helpful to have additional support from a team who are experienced in the delivery of care to patients facing a life-shortening illness. It may be that someone wants to talk about deeply personal and sensitive topics surrounding their mortality and the impact this may have on their families or perhaps they are struggling with a distressing/troublesome symptom which is not being resolved by the other health care professionals involved in their care.

Do you only care for people with really complex needs?
No, as a specialist palliative care provider there may be times when our skills can be useful in less complex situations or when a patient is not in the palliative stage. We believe in supporting people throughout their disease pathway and if our skills can be effectively used then we will help. We encourage anyone to contact us to discuss how we may be able to help and sometimes that telephone contact or visit is all that is needed.

How can you tell if a disease is in the palliative stage?
If the treatments are no longer aimed at curing the disease but are focussed on achieving the best quality of life for that person then this is defined as the palliative stage. There can be difficulties defining just when this palliative stage starts particularly with some long term health conditions such as heart failure, multiple sclerosis or chronic lung conditions because there can be frequent acute episodes of illness which may or may not lead into the palliative stage. Short term specialist palliative care may still be appropriate at key times even though the patient hasn’t a definitive palliative diagnosis. Thankfully treatments for cancer patients have also improved over the years and some people with cancer are living for very much longer despite having a palliative diagnosis. Discussion with the Hospice team can help to determine if our specialist skills would be helpful.

What do you mean when you say you are a specialist palliative care service?
This means that our team has had specialist training in providing care to people with advanced and progressive disease, they are dealing on a day-to-day basis with people facing these situations and are also supporting patients and families with end-of-life care and bereavement issues. They also work closely together sharing different professional skills in order to best meet the needs of the patient and/or families and work collaboratively with other county wide Specialist Palliative Care Services. Our team’s training and experience therefore means they have become skilled in helping people in more complex situations.

Who is in your team?
Within our care services we have nurses, therapists assistants, therapy assistants, counsellors, bereavement support workers, social worker, lymphoedema nurse specialists and creative therapists supported by a team of volunteers with a variety of skills and expertise which complement the work we do. The wider team also includes our CEO, admin and education personnel and our income generation team. We are also supported by our friends groups, local community and our nine shops and the staff and volunteers within them. We have a Facilities and Resources department which includes our cook and cleaner. Our reception staff are probably the first people you will have contact with and they include employed staff and volunteers. Our Board of Directors are all volunteers and they oversee the work that we do.

Once someone comes to the Hospice, does it mean they have a permanent place?
Every person’s situation is individual and therefore it is always difficult to determine how long a person needs our services for, however by offering an initial programme of care it gives the person affected by the illness and the clinical team time to determine the best approach Whatever service is accessed an initial assessment is made and a plan agreed. The Day Therapy service for instance offers a twelve week programme, this is then reviewed and if appropriate extended for a further few weeks. This review process is very important as it is an opportunity to examine if the right approach is being taken and takes account of any changing circumstances. The Hospice actively encourages an open access system by welcoming informal contact for advice and support even if the patient no longer attends. We like to think of ourselves as always being available in the background should people wish to re-establish contact us. We therefore actively encourage telephone contact or informal visits to enable this access to be as open as possible.

Is there a charge for any of the services?
All services are free of charge. Donations are always very welcome as the Hospice has to raise significant amounts of money in order to maintain and develop our services.

How do people get referred?
There are lots of ways in which this can happen as we want to make this process as easy as possible. Anyone (health and social care professionals or members of the public) can telephone the Hospice and ask to be referred or can refer someone else. In all cases the person being referred must have given their consent for this to happen. Sometimes family, friends or neighbours may want to first talk about whether a referral may be made and gain information before talking with the patient themselves as this can be really helpful. More information and downloadable referral forms are available on this website.

What happens when someone is referred?
This depends on the service the person has been referred to but a member of the hospice team will make contact to discuss what happens next. We try to respond as quickly as possible. We always ensure that the person being referred is aware and agrees with the referral taking place. If someone is very anxious then is can be helpful to come and look around on an informal basis and to meet some members of staff. Please do phone us if you feel this would be useful.

How can the Hospice deal with my spiritual or religious needs?
The Hospice welcomes anyone whatever their spiritual or religious beliefs. Spiritual care is not necessarily the same as religious care; it refers more to our individual search for meaning and purpose to life and means different things to different people. Our pastoral care team of volunteer chaplains are available to offer their services by helping people to explore their religious and spiritual needs and if unable to help they have a wide network of resources so will identify others who may be able to. The Hospice believes that we all have a responsibility to help people address their spiritual needs. We also recognise that working within the environment that we do that our own spirituality may be challenged so our pastoral care team cares for the carers too.

Does the Hospice do anything to make death come sooner?
No, that is not what a Hospice is about. Death is a normal process of life and just as giving birth requires specialist help at times so too does the dying process. Hospices have staff that can help alleviate pain and psychological distress and sometimes staff can help in really difficult situations such as when decisions around resuscitation may need to be taken. The most overriding principle at all times however is that privacy and dignity is maintained.