Al Malath Foundation

The home hospice has 6 full time team members:

• the director Rana Hammad, a specialist nurse
• physician Dr Mazen Al Bashir
• four nurses – two are case managers

The team can call on a further 4 part time members:

• pain specialist
• social worker
• dietician
• religious cleric

Volunteers support the team. Families are supported to give care. Hospice physician Dr Mazen Al Bashir describes how the care givers in the family can be taught to manage infusions:

‘they know exactly whatever it [pump IV infusions] means, what it means when it’s up, when it’s in, and how to check that, and to check the rate; and they know how to use calculator to work out exactly how much to take. Of course, you cannot just put it in and turn your back, you need to make sure they are safe, we have nurses which can supervise this sort of thing and many of the people had nurses there looking after them.’⁴³

The case managers are experienced hospice nurses who offer full support for the patient, from nursing procedures, personal care and social needs, including grief therapy for families. They will call on other members of the team as needed, for instance, medical, additional nursing or psycho-social support. Director of Al Malath, Rana Hammad explains:

‘[The case manager] has her mobile, if she sees anything she will call me, she will call the physician, we act on things. She will train the family, she will look out for the family, she will deal with the patient, look at possible troubles to come, do all the adjustments at home, check the medications, check the symptoms, check the life signs, check the body. If she needs a blood test she will order blood tests. She will follow the schedule for changing the dressings or the catheters, or it’s the time to check the haemoglobin or check the potassium. If there is a need, she will arrange with a physician and go with him.’⁴⁴

King Hussein Cancer Center

The hospice team have a total of 30 full and part time members:

• Team Director: Dr Amal Bandak, Associate Director of Nursing and Patient Affairs
• Medical Director: Dr Mohammed Melhem
• Nurse Manager: Suhair Diebes
• Palliative & Hospice Care Physician: Dr Mohammed Bushnaq
• Home Care Co-ordinator Nurse Ra’fat Al Mashni
• Unit Head Nurse: Rena Halasah
• Consultation Team Coordinator: Nisreen Al Alfi
• 19 nurses
• psychologists
• social worker
• physiotherapist
• nutritionist
• Team secretary: Radah Lambaz.

The team is supported by other departments at KHCC if the patients or their families request admission for pain and symptom relief. Spiritual counselling is sought from outside clerics at the request of the family. Team members will offer whatever spiritual solace they feel is possible.⁴⁵

The new palliative care training schemes for physicians, nurses and pharmacists have resulted in palliative care knowledge disseminating into the workforce within large oncology units such as at Al Basheer Hospital and also within the new governmental family and community medical centres. In May 2005 there are, as yet, no records of the capacity of this newly trained workforce or the level of care offered.⁴⁶