A senior community nurse tells Tony Wenham how a patient's plight will help to leave a lasting legacy for the people of Norfolk.
When the surgeons removed one of her breasts, that was OK; also she could accept the loss of her womb and part of her bowel. But when her hair began to fall out in the follow-up treatment, she felt she had "lost her crown". She was in her thirties.
"Cancer is no respecter of age," says senior community nurse Janine Cott, who works in the Hospice at Home team covering south Norfolk, providing support and care to patients and families with life-limiting illnesses who are approaching death.
"We have patients of all ages, but we are not dealing just with cancer sufferers. We support our patients approaching end of life in their homes, regardless of cause."
The patient so affected by the loss of her hair struck a chord with Janine, whose work for the Norfolk Community Health and Care NHS Trust brings her into constant contact with Priscilla Bacon Lodge, the specialist palliative care centre in Norwich.
"The Lodge is such a lovely place, but there just aren't enough beds," says the mum-of-two, who lives at Cranworth. "More people are living in Norfolk and most are living longer, so we need a bigger and better service."
With a £12.5 million appeal for a new Priscilla Bacon Hospice under way this year, Janine had her head shaved in public to do her bit for the appeal, raising more than £2,600.
After 40 years, the Priscilla Bacon Hospice trustees are backing a new state-of-the-art centre, a new-build 24-bed hospice to be built on a semi-rural site close to the Norfolk & Norwich University Hospital.
Norfolk needs 47-59 specialist palliative care beds, but has just 16 - all in Priscilla Bacon Lodge. Ever-increasing demand for inpatient beds as well as day and respite care means that greater capacity is desperately needed.
The new hospice will offer the most modern facilities, plus a wider range of community day care and out-patient services, giving those who require care a greater breadth of choice.
Like the current Lodge, it will focus on enabling a "good death", caring for patients and supporting loved ones through and beyond bereavement.
Currently, the appeal stands at just short of £4 million.
"It will be great for the people of Norfolk," says Janine, a qualified nurse for seven years who has been with the Hospice at Home team since its inception in September last year.
"There's something about palliative care that is really rewarding. It's a privilege to do this job, to be able to fulfil a patient's final wishes, to help keep them where they want to be, it's an honour."
Hospice at Home teams - typically staffed by 11 specialists across disciplines including senior nurses, occupational therapists, assistant practitioners and healthcare assistants, a triage nurse and lead nurse co-ordinator backed by end-of-life care facilitators - operate in north and south Norfolk and Norwich.
The 24-hour service aims to allow patients to remain in the preferred place of care and death, avoiding unnecessary admissions.
"Our team office is based on the Priscilla Bacon Lodge site on Unthank Road and we often go over to help on the ward," says Janine. "It helps us to keep our skills up and we might have one of their nurses to help us sometimes.
"We get referrals from the Lodge and we have patients who go to the Day Centre, although most have a very short prognosis and need more care than their families can provide. Others may become in-patients - we aim to let people die at home, but unfortunately it's not always possible."
Inevitably, the work takes an emotional toll. "We have coping mechanisms," says Janine. "We all talk a lot and that helps and we have a very sympathetic manager.
"I spent a lot of time with that patient who lost her hair, we were about the same age. Sadly now she has passed on."
Find out more about the Hospice at Home teams here
Find out more about the Priscilla Bacon Hospice appeal here
Heading for a big fundraiser
Inspired by the plight of a cancer patient, senior community nurse Janine Cott had her head shaved at a festival in Norfolk this summer to raise money for a new hospice appeal.
"My colleagues and I were talking about ways we could fundraise and I jokingly said I would shave my head," she explains. "I remembered one of my patients who had lots of surgeries, but the thing that upset her most was losing her hair. I thought if I can shave my head out of choice and raise some money, why not?"
VW fan Janine, whose Beetle "Betty" transports her on her visits with the Hospice at Home team in south Norfolk, took to the stage at the recent VW FAB Festival at Strumpshaw Steam Museum for the head shave.
The combined total raised by Janine and other fundraising activities at the event currently stands at £2,602, but donations can still be made and the festival has chosen to make the appeal its permanent chosen charity, so funds raised at all future events will benefit the cause.
Support Janine and the Priscilla Bacon Hospice appeal here.
Email or call the fundraising team on 0330 223 4274 if you can raise funds in support of the Priscilla Bacon Hospice appeal
Who cares
Specialist care is provided in the inpatient unit and the day unit at Priscilla Bacon Lodge, and in the wider community, by the Community Specialist Palliative Care team and the Hospice at Home service by Norfolk Community Health and Care NHS Trust.
Other services include medical outpatients and treatment clinics with advice on pain control and management of symptoms, occupational therapy and physiotherapy, psychological support clinics, spiritual and emotional support for patients, family, friends and carers.
There are also complementary therapies, information on conditions, their treatment and any additional support available.
The centre's multidisciplinary teams work closely together and with GPs and community nurses, as well as other health or social care professionals involved in a patient's care.
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