Kate Bradford
Kate Bradford

Bringing Hospice Care into the Home: How ellenor Meets the Needs of Life-Limited Children in the Community

In casual conversation, it’s not always easy to explain that you work in palliative care – particularly not when it concerns children. It is something that Kate Bradford, who has spent her career providing clinical care and treatment to young people, is all too aware of.

“It’s a conversation stopper” Kate explains, “people don’t think about young children’s hospices, or children dying, because it’s too hard. We have to explain to people that we focus very much on life – and how we can make the most of life – as opposed to dying. But also, that it’s about giving people a space where they can talk about death, and prepare for it.

Making it about what they can do, and the life that they can have, despite having a life-limiting condition, is the way forward.”

Children's Services at ellenor

The Children’s Care Services at ellenor are responsible for providing care to babies, children and young people facing a range of life-limiting illnesses and conditions (0-19 years). Until recently, Kate worked for ellenor as interim Operational Lead -  Children's Services.  

In Dartford, Gravesham and Swanley, ellenor provides clinical nursing support working with children’s families to provide care at their place of choice, which is often in their own home. This means the children can receive care in familiar surroundings. Additionally, across Dartford, Gravesham, Swanley and Bexley we provide respite and wellbeing services which include, Play Therapy, Music Therapy, Counselling, Bereavement Support to mention just a few. 

To achieve this, we work closely with other local and UK-wide organisations, including Demelza and the Community Children’s Nursing Team, as well as hospitals such as Great Ormond Street and the Evelina for referrals, and to ensure that the entirety of the patient’s needs are being met.

All our Children’s Care Services take place in the community. Kate’s team works with the family from the point of the child’s diagnosis, to ensure a smooth transition from hospital to home. 

Children's Services at Home

It’s something that, according to Kate, affords comfort for both the children and their parents.

“They want to be home. They want to be somewhere their family can visit, where they can all be. They have siblings, pets, and support. Lots of parents of children with life-limiting conditions will have spent a huge amount of time in hospital already. Home is the environment that a lot of them choose, and it’s nice to be able to provide that.”

Being welcomed into the homes of patients, Kate also says, is “humbling”. 

“It’s such a heavy, meaningful time. Families are grieving for the life they thought they and their child would have, and to let you into that is really hard. It’s a massive privilege to be not only accepted but welcomed into their homes – to be able to build relationships with them.”

“They’re going through so much, and they’re still able to talk to you about the mundane stuff. There’s still the humour, still the little things – even when you’re dealing with the big things.”

Getting to Know You

A particularly strong relationship that Kate had was with a patient described by one of her consultants as “magic on two legs”. As Kate explains, “That was this child. She was the embodiment of everything good in the world; she was just the best. To be able to take her family though the process of her, sadly, dying, was really special to be a part of. Although it was hard, it was so nice to have that bond with the family, and to be able to see them through that time.”

Providing care directly from the patients’ homes also allows Kate’s team to offer the holistic care ellenor is known for – that is, to treat the individual and the family, rather than the illness alone. This involves supporting families with counselling and complementary therapies, as well as helping the child and their siblings express difficult emotions via innovative play and music techniques.

Parents and children are also invited to attend ‘Fun Days’ – one recent example being a socially-distanced pumpkin pick – where they can relax and meet other families we are supporting. 

Volunteers and Medical Professionals Working Together

Here, Kate is keen to stress how crucial the role of volunteers play; from dressing up as Santa or the Elves at a Christmas party to providing DJ services for the night. The generosity of the local community is instrumental in allowing our Children’s Services to continue their vital work but the team is always looking for additional support.

Yet the driving force of our Children’s Services is the skill and dedication of its nurses. The team are constantly on the lookout for passionate individuals looking to make a difference in the lives of children and families facing life-limiting illnesses.

There’s plenty of development and on-the-job training, especially from the kids themselves! So, what has Kate learnt from the children she works with?

“Humour. Humility. Resilience. It’s different to the adult world – we whinge if we have a cold! We’ve had kids with really serious complications, with rubbish illnesses. They don’t sit around, or mope – they ask ‘What can I do?’ or ‘How do I get on with it?’”.

For Kate, these are the kind of lessons that leave a lifetime impact.

“You get patients every now and then that change your career. They change the way you see the world.”