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'There is life left to be lived – let's find a way of giving it meaning'


By Alan Hendry

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Ian James Hospice Lucky Numbers, Highland Hospice, Hospice, Hospice Lucky Numbers
Ian James Hospice Lucky Numbers, Highland Hospice, Hospice, Hospice Lucky Numbers

"I CAN definitely say this is the best job I've ever had," says Ian James. It is also, he is quick to add, the most emotionally demanding.

Ian, one of three occupational therapists based at Highland Hospice, is sitting in the craft room at Ness House outlining the day hospice service provided here in Inverness and in other communities across the region.

All around there is evidence of colourful creativity – from a set of crockery in a fetching shade of lime green, left to dry on some old newspapers, to a wacky papier-mâché dog called Fergus... constructed mostly from urine bottles and bedpans.

The first impression may be of a high-school art class, but there are none of the pressures of an educational establishment here. Instead it is part of a small network of welcoming places where people with incurable life-limiting illnesses can come together, share some of their experiences if they wish, and benefit from the expertise of the hospice professionals.

The day hospice is held in Inverness three days a week, with fortnightly outreach sessions in Caithness, Sutherland, Lochaber and Skye. Patients are referred by their own doctors, by district nurses or by the Macmillan nursing team.

"The whole aim of the outreach is just to extend what we do here outwards and we rely hugely on volunteers to get folk in and spend the day with us," Ian says.

"People give themselves a terribly hard time because they can't do what they used to do. They feel it's their fault: 'I'm failing.' So a lot if it is permission-giving and understanding it's the illness – it's not you, it's not your fault.

"I would say we notice that as people come here over a period of time they become less anxious and less frightened, despite the fact that their physical condition will continue to deteriorate.

"If you're starting to lose yourself, and lose the things that you used to do, maybe there are things in this craft room that you can do.

"If I had a pound for every time somebody came through that door and said, 'I'm no good at art, I haven't done it since I was at school...' Everybody tends to think they're going to be judged. After a while, people realise that we're not judging anybody in here."

There are discussions aimed at helping people to maintain their independence, covering topics such as mobility, fatigue and the effects of chemotherapy. It is, to a great extent, about "getting on with life", he says: "There's life left to be lived. Let's find a way of giving it some meaning and purpose if we can."

Life story work is something that Ian finds especially fulfilling, while remaining respectful of those who prefer not to delve into their personal history.

"Some people have an enjoyable time doing it, despite the context that they're coming to the end of their lives," he says. "It's the pleasure of rediscovering and remembering the things that you've done, and reflecting... But not everyone's life has gone well, and some people want to edit things out or not reflect because it has been tough for them. So you have to be terribly empathic about entering into that process.

"I've had some younger women, who have got children, who have really gone in for it in a big way because they see that as some sort of legacy and a way of seeing past their death, to leave something that is of value for the kids. We've had people in here decorating pottery, 'Love to such-and-such,' right up until a week before they've died.

"We do have sad conversations, and people have difficult stories they want to tell. But generally speaking people do seem to want to get on with life here, and not think about that all the time, so we offer the range."

That range may be expanded in years to come through a "virtual hospice", bringing outreach services to people in remoter areas who are unable to get along to the existing sessions in Inverness, Thurso, Dornoch, Fort William and Portree.

"We've very much in the exploratory stage of that," Ian says. "Our little dream is that maybe, with a reasonable quality of broadband link, there would be six people on a screen meeting together with us as a facilitator and we would try to re-create what people are getting here in the day hospice in that form. They're not going to be able to do pottery directly. But the discussions, the sharing, the reminiscing... all that, I'd like to imagine, could be done."

For now, the focus is on making the existing provision as beneficial as it can be.

"Living life to the full within the limits of your illness – that's our overriding aim," says Ian, who has been with Highland Hospice for nine years, having come to Inverness in 1995 to work in community mental health.

He is full of praise for the hospice team as a whole, from the medical experts to the housekeepers who, he says, are the "life and soul" of the place.

"It's very much a team thing," he says. "The doctors and nurses get people well enough for us AHPs [allied health professionals] to do our bit as well. We're all equals here.

"There's a philosophy among those of us who work at the hospice that we're all in something together.

"The hospice is like a family, really."

Outreach provides region-wide support

DAY hospice services are provided at Inverness three days a week, from 10am to 3pm, designed to help people maintain the best possible quality of life.

In addition there are fortnightly outreach sessions in different locations around the north: North Highland Cancer Information and Support Centre, Thurso; Dornoch Social Club; the Macmillan Cancer Information and Support Service at Fort William Library; and the MS support centre in Portree.

Community transport services and volunteer drivers help to take patients to and from these venues.

Mary Maclean, of Mackay Road, Inverness, is the latest £500 winner of the Hospice Lucky Numbers weekly prize draw.


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