Palliative and end of life care in Ilford: what a nursing home can do, who else is involved, and the questions to ask

What palliative care means in a nursing home

Palliative care is care for someone whose illness cannot be cured, aimed at comfort, dignity and the best possible quality of the time that remains. It can last months or years, for someone with heart failure, lung disease, advanced dementia, Parkinson's or cancer, and end of life care is its final part. In a nursing home it means a registered nurse on duty who can give prescribed pain relief and other medicines, recognise when symptoms change and call the right person, and care staff who help with comfort day and night. Woodlands provides comfort-led palliative care that respects the person's faith and wishes; ask how the home would manage a specific need, such as a syringe driver.

Who is involved

• Woodlands' nurses and carers, day and night, who deliver the care and coordinate everyone else.
• The resident's GP, who prescribes, reviews and agrees anticipatory medicines so that pain, breathlessness, sickness and agitation can be treated without delay.
• The community palliative care team for Redbridge, who can advise on symptom control.
• A local hospice, where one is involved. Saint Francis Hospice in Havering-atte-Bower serves parts of Redbridge; ask the GP which service covers the person's address.
• Community nursing services, which the GP can arrange where extra support is needed.
• The family, whose knowledge of the person shapes every decision, and a chaplain, imam, priest or pandit where the resident wants one.

Planning ahead

The best palliative care starts with a conversation while the person can still take part in it. It helps to discuss what matters: where they would want to be cared for, whether they would want to go to hospital if they became very unwell, what they would and would not want done, and who should speak for them. Those answers can go into an advance care plan and, where appropriate, a ReSPECT form, which records treatment and resuscitation decisions so that a paramedic or out-of-hours doctor knows what the person wanted. A lasting power of attorney for health and welfare lets a relative make decisions if the person can no longer do so; it has to be set up while the person has capacity.

What we do in the last weeks and days

Pain and other symptoms are treated under the GP's prescriptions. Mouth care, repositioning, skin care and help with eating and drinking for as long as the person wants it are the daily work, and food can become what the person fancies. Ask us about family visiting at this stage, including staying overnight. Where assessed needs call for constant presence, one-to-one care can be agreed. Faith is respected in the way the family wants, whether that means a priest, Quran recitation, prayers, a lamp or silence. After a death, ask the nurse in charge what happens next and who will contact the GP and the funeral director.

Dementia and palliative care

Advanced dementia is a terminal illness, though it is rarely described that way to families. Woodlands' dementia care can continue into palliative care where needs can be met: signs that a person is entering the last phase, such as repeated infections, weight loss and difficulty swallowing, are a reason to talk with the family and the GP about comfort, and about whether a hospital transfer would help the person or distress them.

Paying for palliative care

Someone who is deteriorating quickly with a terminal condition can be assessed for NHS Continuing Healthcare under the fast-track pathway, which is completed by a doctor or nurse and should be decided quickly; if granted, the NHS pays the full fee. Anyone assessed as needing a registered nurse receives NHS-funded nursing care, a weekly contribution paid to the home. Otherwise the London Borough of Redbridge means-tests the person against the 2026/27 capital limits. Ask the GP or a nurse about the fast-track pathway as soon as the person's condition changes; families often do not know it exists.

Questions to ask any nursing home about end of life care

• Is a registered nurse on duty at night who can give end of life medicines?
• Do you use anticipatory prescribing, and how quickly can a syringe driver be started?
• Which community palliative care team and hospice support the home?
• Can my relative stay here to the end rather than going to hospital?
• Can the family stay overnight?
• How are religious needs met at the end of life?
• Do you help with the Continuing Healthcare fast track?

Coming to Woodlands for end of life care

You do not need to have lived at Woodlands to ask about palliative care here. A person may be in King George Hospital with a family who want a quieter place than a ward, or at home with a carer who can no longer manage the nights. Admission depends on an assessment of their needs and on availability. Ask how medicines and equipment would be arranged with the GP and the ward before the move.

Talking to Woodlands

Woodlands Total Care Nursing Home is on Gordon Road, Ilford IG1 1SN, near Ilford station on the Elizabeth line. For a conversation about palliative care, whether for a current resident or for someone at home or in King George Hospital, call 020 8553 2841 or use the contact form. We will talk through what the person needs now, what is likely to come, and what we can put in place.