WHEN Salma Khan’s husband was diagnosed with terminal cancer, she was grateful for the help that they both received from a dedicated nursing team.

The nurses helped with the needs of her husband, and Salma’s own problems that arose as a result of his illness.

Bradford District Care Trust’s Specialist Palliative Care Team – in particular its liaison officer Wali Nazar, based at Marie Curie Hospice – supported the family through this difficult time and after Salma’s husband died.

Palliative care patients are those who are estimated to be in the last year of life.

The team, offering help including specialist palliative care, hospice and home care, helps people aged 18 upwards who have a life-limiting condition. In Bradford, about 1,200 people annually are affected.

“This can be anything, from cancers and blood disorders to chest and heart problems,” says Belinda Marks, clinical lead for palliative care at Bradford District Care Trust.

Six Macmillan nurses offering palliative care give advice. “This may be about pain relief, symptom advice, or psychological distress,” says Belinda. “If people have social or financial issues we would liaise with others to help with that.”

The team – which was recently praised in a report by the Care Quality Commission – also includes a social worker, a psychologist and two ethnic liaison workers.

“It can be a very emotional and distressing time,” adds Belinda.

“Team members are specially trained to be able to communicate sensitively, to provide comfort and reassurance as well as practical help. We speak to patients on their own, or with family there if they consent. We are able to pick up whether they want to talk or not. We can also talk to patients about what they would like at the end of their life – who they would want to be there, what treatment they may or may not want and what music they want to hear. Often, relatives find it comforting to know what they want at the end of life. If someone loses consciousness in their last days, it is nice for the family to know what music they wanted playing.”

A special team provide care for the last months of a person’s life. “This could include a person wanting to die in a preferred place, usually at home,” explains Belinda. “We would help with the necessary equipment such as beds, commodes and hoists, and organise Marie Curie night nurses and district nurses.”

Funerals can be discussed. “People usually want to prepare their family,” says Belinda.

Some people are very open, but others may not want to talk about their end of life. “We have to be tactful – this is already a very, very distressing time. This is why it is important to build up a relationship with a patient. It is not just about one visit, it can take time, over weeks and weeks, to gain a patient’s trust.”

Adds Belinda: “If a patient is in denial, we work with what they want to tell us. That is their way of coping. We would not pry.

“It is about working things through with them. It is being with them, knowing that there is someone there who empathises with them. Our role is not just for the patient, we support carers too – we visit, but they are there all the time.”

People may have concerns that they are going to be in pain, so are advised on how to manage their symptoms.

“We tell them we will do our best to alleviate it. We offer hope but don’t give them false expectations.”

Some patients may live longer than is expected, says Belinda.“Often people can go on living for years and we can then help them with their symptoms. Some people want to go out and do as much as they can in a short time and have bucket lists.”

“We work with patients before the district nurses take over. They know all the patients and are the key workers who provide specialist advice.”

The teams work closely with district nurses and GPs who may refer patients, or referrals may come from hospitals or hospices.

Team members are supportive of each other and are able to speak to a psychologist if they feel the need.

As a result of Salma Khan’s experiences, she became a volunteer at the Marie Curie Hospice and has recently gained permanent work with the charity.

Adds Belinda: “It is a privilege to do this job – for people to let you in, at a very difficult time in their lives. You hope that you make a difference.”

bdct.nhs.uk; 01274 323511.