When I received the second referral for our man with Chronic Pain I decided to be a bit more careful. Again he didn’t fit within our referral criteria, he didn’t have a life limiting diagnosis which is usually one of the non-negotiables for people under our care. That’s what it looked like on paper, but I will always give a person the benefit of the doubt. We only decline a small number of referrals to our service and most people will have at least one face to face assessment. I decided to see for myself as I knew him better than most people on our team. I arranged for a home visit later in the week.

The referral had come again from the Pain specialist, again I could not see a life limiting illness diagnosis but I wanted to give the patient a fair chance. I went out to his home to meet him and his wife. I hadn’t seen either of them for almost two months. He looked much the same as I watched him walk out of his bedroom to his lounge. He complained of pain worsening since changing from injection medications to by mouth medications. He had developed a small ulcer on his lower leg, but it did not look infected, and he had no symptoms suggesting a severe infection. His pain had been there for almost a decade and I knew it would never go away.

I tried my best to find something that would allow him to access our service but I couldn’t find anything. I could find no life-limiting illness and said to the couple that I didn’t think our service needed to be involved at this stage. If his situation worsened in the future then we’d be happy to be involved in his care again, but at that moment I had to decline to have him back on our service. They were both understanding of the situation and we parted on friendly terms with hugs shared.

As I was about to leave their house his wife asked me how long I had worked at hospice. I said I’d been in my position for almost 12 years, but I had actually worked there about 14 years ago when I was a registrar completing my specialist training.

“That’s where I’ve met you before.”

“Oh, that’s a  long time ago.”

“Do you remember looking after a 16 year old patient?”

“I haven’t looked after many 16 year olds in my time at hospice. I do remember a 16 year old girl.”

“She was all alone, her father was overseas when she was admitted to your hospice. She needed a mum, but her real mum had died. All the staff were surprised when the girl said her Mum was coming and instead I turned up. I was her mum for the weeks of her hospice admission.”

“That was you? It was a lovely thing you did for our patient who was dying all alone, thousands of miles from her home country. Thanks for stepping up.”

“It was my pleasure, it’s what me and my husband have done for most of our lives, helping people out from our church and outside of the church.”

“Thank you it was a wonderful thing you did for her. I do wish you both well. If you need us in the future, we’ll be there for you.”