“PEOPLE say, when they come in the building, it feels like a hug,” says Joyce Bellingham, operations manager at St Kentigern Hospice, as she leads the Journal on a tour of its St Asaph premises.
Indeed, from the display of frequently-replaced thank-you cards pinned to a noticeboard, to the conversations repeatedly punctuated by background hollers of laughter, or the receptionist who’s popped in on her day off, there’s a warm glow emanating from these corridors, a far cry from the more sombre mood you may expect in this environment.
It’s Monday morning and, in the hospice’s community café, Caffi Cariad, where its chicken, cheese and pepper panini will later go down a treat for lunch, the hospice’s “Knit and Natter” group is in full swing.
The hospice’s recent expansion in 2020, which included the café’s opening, is just one of its many developments Joyce has been a part of, having worked at St Kentigern for almost a quarter of a century.
In that time, she’s watched it “grow and mature” from its early beginnings in the mid-90s, to a facility which now offers a far wider range of services to those with life-limiting illnesses in North East Wales, maintaining a human touch all the while.
And it’s definitely easy to see why inpatients at the hospice, which offers 24/7, 365-days-a-year specialist care, would feel at home while staying in one of the hospice’s 12 rooms, which grew from eight following the 2020 refurbishment.
Whether it’s the more practical elements, like the ensuite bathrooms and bed hoists, or its aesthetic appeal, such as pictures taken by staff members of North Wales scenery and wildlife hanging on walls, rooms have been designed with the specific aim of giving patients “the ultimate control”.
Patients’ rooms are also adjacent to an outdoor patio area, where a backdrop of cows grazing in spacious fields lends it a sense of serenity.
Elsewhere, a side gate enables visitors direct access with their loved one, while an outdoor counselling cabin was also recently installed here.
“We try to make it as friendly and comforting as possible, without it being too clinical,” Joyce says.
“I was returning to work from having children, so I took a part-time admin job here. Once I got into it, I never came out of it. I’ve done everything; I love it. It's my passion.
“The way I see it is that we’ve done something to help someone. I’ve had loved ones die here as well, but because of the support they’ve had, it's really heart-warming.”
It’s in another particularly tranquil setting, the Forrester Lounge, where ward sister, Emma Parry-Jones, recalls treasured memories of helping patients realise their dreams as they approach their final chapters.
Also doubling up as a meeting room, patients can put their feet up in front of the television with a brew here - “It’s just like being in someone’s family room!” says a new hospice fundraiser joining our tour.
Emma, who has worked at the hospice for five years, initially as a staff nurse, looks after the inpatient units - whether patients have come to give their carers a break, for symptom management, or for end-of-life care.
But if it may seem a hefty, daunting responsibility, it’s one Emma embraces, rather than allowing it to weigh heavily on her shoulders.
She says: “There’s a perception that you only come to a hospice to die, and that they're very doom-and-gloom, sad places, but if you walk through the unit or talk to staff, it’s a very happy, jolly place to be.
“We look after our patients at the end of their life, and that’s an absolute privilege to do that. Our main philosophy of hospice care is that what matters to the patient matters to us.
“Every day is different. We look at setting goals with patients of what they want to achieve in their last days, and to be able to be part of that is just amazing.
“It could be something as little as that they haven’t seen their cat for two weeks, and that all that matters to them is to have some quality time with their cat, so we facilitate that. We’ve had lots of examples like that.
“Somebody wanted to go and see the sea for the last time, so we arranged for them to be taken to the seaside, and just spend a couple of hours outdoors.
“We’ve had quite a lot of birthday parties here – obviously, they’re too poorly to leave here, so we’ve brought the party to them, in here (Forrester Lounge) or in their bedroom.
“All of the staff rally together, and people go out in their spare time to buy balloons and banners, and the kitchen will make a big cake. It’s just lovely.
“We have a music therapist as well, and if she’s about, she’ll get on the keyboard and play ‘Happy Birthday’ to them, or their favourite song. It really matters, and it feels really good to be part of that.
“All of those things, and for them to have you (involved) as part of their last wishes, give you massive job satisfaction.”
There’s no shortage of services available to outpatients, either, be it one-to-one and group music therapy on Thursdays, or “Table Talk” each Wednesday afternoon.
That’s as well as a six-week course of complementary therapy treatments, and a fatigue, anxiety and breathlessness group, facilitated by the hospice physiotherapist.
And boasting activities like the hugely popular Boccia (indoor bowls), bean bag throwing and chair aerobics, the six-week wellbeing programme has proved an enormous success since getting off the ground at the start of 2022.
Based in the hospice’s Wellbeing Hwb, and co-run by occupational therapist Lisa Howson, the course helps those with a life-limited diagnosis and a link to the hospice, while a follow-up call ensures no patient is left behind even after the six weeks are up.
“We look at different practical things that they can do at home to manage energy levels and fatigue,” Lisa says.
“It’s about adapting activities that they do at home, if they’re not able to do things that they used to do before.
“The key is for them to try and manage their symptoms themselves to prevent them from going into hospital, or into here.
“A lot of people get admitted into hospital with shortness of breath, so they can try and learn techniques which would help them at home, and they really do work - they (breathing exercises) are so underrated.”
Certainly, the facilities are in place for patients to thrive on the programme, both in the hospice’s homely “Activity Room”, where armchairs are moved out of the way to accommodate a game of Boccia, or in the “Art Room” brimming with colour next door.
The latter feels particularly therapeutic, with a selection of board games and jigsaws for patients to put their brains to the test with, while its array of crayons and paint brushes have no doubt contributed to the room’s vibrant display.
And in a small yet significant move, its tables, strewn with Jenga blocks, have merged into one, adding a more communal feeling.
Lisa adds: “I think a lot of people are still quite nervous about coming to the hospice, so it’s nice that they come to the Hwb to see what we do, and feel comfortable in this environment.
“There’s still that stigma around people going to hospices to die, so we try to promote the fact that there’s so much more to the hospice than that.
“We’re helping to support people as outpatients, and ultimately then supporting the community, which is a nice feeling.
“They love Boccia, but I think they just like the variety of the sessions and the peer support, talking to other people about the challenges they’re overcoming, and getting advice from people in similar situations.
“They all have different diagnoses and are in different stages of their journeys, but the feedback we’ve had is that they quite like that.
“Say they have MND (motor neurone disease), they don’t want to be in a group with people with MND because they don’t want to be reminded of their diagnosis.
“I think there’s still a role for those types of groups, but that’s why this one is quite unique, because people are coming together who are completely different.
“Inpatients can come across as well and use the facilities while staying here, - the facilities are for everybody.
“We do a follow-up call the week after. While they’re in the group, we do ongoing assessments and they have access to any of the MDTs (multi disciplinary teams) so they can be referred to a physio, advanced nurse practitioners, a social worker, or myself.
“They have access to everybody.”
This support would not be possible, of course, without funding, which doesn’t always come easily to St Kentigern.
It costs £2.1million per annum (£5,350 per day) to run the hospice alone - and the price of running the entire organisation (including retail, lottery and fundraising) is closer to £3m.
During 2022-23, Betsi Cadwaladr Health Board will supply almost £650,000 to support it - but its income generation departments must raise the remaining £2m+ themselves.
The COVID-19 pandemic, of course, exacerbated such issues and plenty more.
Not only, as Emma recalls, were there initially “no guidelines or PPE (personal protective equipment)”, as well as staff “coming into work petrified, day in day out,” but the completion of the hospice’s major expansion, including four extra patient rooms, new inpatient unit and day therapy rooms and Caffi Cariad, coincided with the first lockdown.
Still, in the last two years, the hospice has welcomed roughly 250 new inpatients, and never closed its doors to visitors altogether at any stage during the pandemic, with there now being no limit on when people can see their loved ones.
And while restrictions inevitably narrowed the scope of the hospice’s dedicated fundraising team, half of whom were furloughed during the pandemic, it evidently hasn’t dampened their enthusiasm for the job.
Some encourage other corporates to join the likes of Barclays and the Co-op in sponsoring the hospice, while others arrange its flagship events, such as the six-mile sponsored “Dawn Walk”, or the “Light Up a Life” campaign, which last year raised more than £17,000 alone.
Others will support those raising money for St Kentigern individually as “Hospice Champions” - through activities like swimming with sharks, wing walking (moving along an aeroplane’s wings during flight), or taking on a 127km pilgrimage route in Spain.
READ MORE:
Abergele mayor swims for sharks in aid of St Asaph hospice
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Friends who met in Rhyl complete Spain charity walk for St Asaph hospice
‘Light Up a Life’ campaign raises more than £17,000 for St Asaph-based hospice
Sponsored walk raises thousands of pounds for St Asaph hospice
For Trefor Lloyd Roberts, who oversees the corporate side, was born in the old HM Stanley Hospital nearby and went to school next door, there’s an “emotional draw” to a job he finds as creative as rewarding.
“We’re not national fundraisers. We’re employed directly by the hospice, so every penny that’s given will go into the bank,” says Trefor, in-between raving about the hospice’s lunch with Ann Widdecombe in July and overnight mystery tour in September.
“We like to use community companies to support us, so it makes us very integral, and quite central, to the community.
“There’s not much disposable income around, so we want to make sure that what we're offering is worthwhile, is of quality, and that people see where the money’s going.
“You’ve got to be creative in fundraising these days, particularly with (the changes since) COVID. One of the biggest issues I had as a corporate lead was re-engaging my corporates and ensuring they’re (still) on board.
“We raise the money to allow the nurses to then provide the care, so it’s like a carousel of support. No day is the same, but I love spontaneity and the challenges.
“We’re trying to use the building a lot more now that we’re a bit more open, particularly the café. You come into the café, and you don’t actually think it’s in a hospice.
“One of my motivations to work here was because my father needed palliative care over 30 years ago, and places like this weren’t available then. You either died in a hospital or at home; that was it.
“It’s not an easy job, but it’s a rewarding job. If you’re not emotionally engaged, you can't do it.”
Michaella Brannan, community and event fundraiser, also put together an urgent appeal in January 2021, highlighting the services they could help fund for the various amounts pledged, to give people a connection between the amount donated and the help it would provide.
That made £27,000 within weeks, and led to grants of up to £50,000 from different companies and corporations on the back of that.
Digital fundraising and lockdown challenges were also emphasised during the pandemic, as was encouraging more people to come on board as Hospice Champions.
“We just had to get innovative, and understand that people didn’t have as much to give in certain instances,” Michaella says.
“If you’re furloughed or you’re not able to work, then you haven't got any income to be giving; that’s just the reality of it.
“I think a lot of people have this perception that the hospice is going to be dark, but it’s not like that here at all.
“We definitely take into account that life is short, and that people get terminal diagnoses from early ages.
“It doesn’t have to be (people aged) 70 or 80+. We can help everyone, from different ages and backgrounds.”
Several aspects of St Kentigern shine through so brightly that they are impossible to ignore.
To name only two: the treatment for inpatients and outpatients, as rich in quality as it is in variety, and the unwavering support given “before, during and after” - as Trefor reiterates - to families both pre- and post-bereavement.
But primarily, it’s the fact that little about St Kentigern chimes with the general connotations of life at a hospice - a place where not even a global pandemic could shatter staff morale.
What, then, makes working in such a demanding and emotionally charged environment so worthwhile, so rewarding?
“Knowing that we’ve helped someone,” Joyce says without hesitation.
“Especially the bereaved afterwards. The counselling is so good, especially for children. It’s knowing that they’re going to be OK, and that we’re there to support them.
“We’re always here for them; we never say: ‘That’s it’. All the staff work closely together; they support each other emotionally, and they’re a really good team to work with.”
“We all support each other, and we’ve all got the same mindset,” Lisa says.
“I don’t find it daunting; I see it as more of a privilege to be part of their journey, and feel really grateful to be supported by a fantastic MDT team.
“We’re just such a close team that we always reflect and talk. It can be tough at times, but the rewards totally outweigh any negative aspects of the job.”
“I think people are very anxious about coming to hospices, but once they’re here and see what support they get and our flexibility, they’re very comfortable,” Emma adds.
“If they’re going home after a period of respite, they don’t want to leave us, which is nice to know that we’re doing a good job.
“People say: ‘How could you work in a hospice?’, but until you come here and feel what it’s like and step in our shoes, people don’t understand.”
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