Avneet’s journey as a junior doctor at Pilgrims Hospices: “Pilgrims enables dignity in death”
At Pilgrims Hospices, specialist palliative care doctors and consultants play a vital role in supporting patients and their families.
They focus on managing and improving the physical symptoms that accompany a variety of life-limiting illnesses, with the broader aim of helping people to live well – in both mind and body – in the time that they have left.
Avneet Kaur Dhandee, a junior doctor from London, completed a placement at the Canterbury hospice in 2025. She shares her experiences, including how her Sikh faith informs her medical practice.
What inspired you to do your training at Pilgrims Hospices?
I’m interested in becoming a GP, with special interests in palliative care and mental health, so I felt a hospice placement would be essential to inform my future career. I’ve gained immense knowledge from my time at Pilgrims, and look forward to applying this to my practice, which will include hospitals, care homes and patients’ homes.
What has your role involved and what have you learnt through working at Pilgrims? Has anything surprised you?
Working at Pilgrims, I’ve seen how effective primary care management can aid in reducing the pressure on hospice services, which are mostly funded by charitable donations.
Pilgrims deliver skilled and compassionate end-of-life care, free of charge, to thousands of people across east Kent every year. They provide extensive services in the community, with care teams attending patients in their homes, care homes, and nursing homes. Supporting families is also a key focus; Pilgrims offer dedicated groups, from therapies to legacy work and so much more.
I’ve been able to get involved with delivering many of these services, including:
Clerking in new patients
Identifying actively dying patients and managing their care appropriately
Prescribing effective medication dosages and identifying beneficial choices of analgesia, anti-emetics, laxatives, and syringe drivers
Visiting patients at home alongside the medical team
Throughout my placement, I was guided and supported by a consultant and the wider Pilgrims team, who are all amazing!
I initially associated hospice work with sadness, grief and anguish, but I felt so much gratitude during my time at Pilgrims. Whilst some negative emotions are definitely more real than ever within the hospice environment, positive feelings shine through; families share their gratefulness for the care, patients express relief as they become the most pain-free they’ve ever been, and it’s lovely to see the comfort people feel thanks to the kindness shown by staff.
Do you have any favourite memories from your time at Pilgrims?
Something I’m most proud of is taking part in the Pilgrims Way Challenge 2025, which took place whilst I was working at the hospice. I completed the challenge with my medical school friend, Sana. We walked 35km from Dover to the Canterbury hospice, on a very hot day! When we crossed the finish line, we were cheered on by the wonderful ward nurses and patients.
Sana Hussain And Avneet Kaur Dhandee 1
Sana Hussain And Avneet Kaur Dhandee 2
Afterwards, I visited the hospice and showed my medal to the nurses and patients I’d been looking after. I was particularly emotional and overwhelmed by the donations I received from family, friends, staff, patients and patients’ families – with messages including “thank you for your kindness and care towards my sister” and “thank you for being the best doctor I’ve met.”
Sana and I are proud to have raised over £2,600 for Pilgrims!
Did you have any preconceptions/assumptions about hospice care before coming to Pilgrims?
I thought hospice care was only for those at the end of life; I imagined sick people who were very close to dying. I now know that it often starts much earlier, when life-limiting diagnoses are made. Not everyone comes to the hospice to die; symptom control is a key reason for referral, to help enable patients to live well in the community. Pilgrims has a dedicated team for community visits, which expands care beyond the hospice walls.
Why is hospice care important?
I practice the Sikh faith, and am inspired by many Sikh values in how I live my life. Core aspects of the Sikh ethos include the Panjabi terms “sewa” (selfless service) and “daya” (compassion).
As hospices are almost completely charity funded, they are a prime example of sewa and daya, helping to better thousands of people’s lives and their experiences of end-of-life care, every single year.
Not only do hospices support patients with life-limiting conditions with their physical symptoms, they also support both patients and families with the psychological challenges faced at such an emotional time.
Why do we need to talk about death and dying, and how does Pilgrims help people to do this?
I’m inspired by Bhagat Puran Singh Ji (1904-1992), a prominent Sikh personality who was a humanitarian and environmentalist. He founded Pingalwara in Amritsar, a refuge for the sick, disabled, destitute, and abandoned, which developed into a charity that continues to flourish, expand and serve hundreds of thousands.
Bhagat Puran Singh Ji once stated: “Dignity in death is a birthright of each living thing.” His advocacy for death with dignity centered on ensuring that those who were terminally ill spent their final days in cleanliness, comfort, and love, without suffering – allowing them to die peacefully, cared for, and respected.
I believe these teachings and acts of service that I have looked up to are naturally been embedded within Pilgrims’ vision and care. Pilgrims encourage patient and family involvement from the first assessment and beyond – ensuring that patient wishes and dignity are upheld to the best of our abilities. As a multidisciplinary team, we all strive to work together in assessing needs, prioritising patient comfort, providing wider support to family and friends, and ensuring patient wishes are at the forefront of everything we do.
Pilgrims Hospices provides compassionate, specialist care free of charge to thousands of people in east Kent each year who are living with life-limiting conditions. Support is offered in patients’ homes, in the community, and at our three hospice sites in Canterbury, Thanet and Ashford. We also run a 24-hour advice line.
27th October 2025
Pilgrims Hospices helps Margaret to realise musical theatre dreams
Margaret Grand from Wingham grew up in Canterbury. With a keen interest in singing and theatre, she did choral singing at school and sang in choirs later in life – including with Ann Robertson, Pilgrims Hospices’ founder, who Margaret knew from her village community.
John and Margaret on their wedding day
As a teenager, Margaret was offered the opportunity to study at the prestigious Italia Conti performing arts institution, but her mother wouldn’t let her go; Margaret was an only child, and her mother was afraid she would move away and not return home.
Margaret instead began working at Boots in Canterbury city centre, where she met her husband, John, who was also a musician. Together, they played in bands and performed locally.
In 2021, Margaret was diagnosed with cancer and received a life-limiting prognosis. Since being referred to Pilgrims Hospices, she has had a second chance to flex her theatrical prowess through a project with the Marlowe Theatre – showing how hospice care is not only for those at the end-of-life, but also empowers people to live well, and fully, in the time they have left.
Margaret said:
“I’d had problems with my leg, I kept getting cellulitis; I was going to the GP surgery regularly to have dressings on. The nurse noticed a spot on my leg, which started to change colour, so she asked the doctor to check it and he did an urgent referral. A biopsy at Kent & Canterbury hospital showed that I had Merkel cell carcinoma, a rare type of skin cancer. The nurses explained that I’d need to go to Queen Victoria Hospital in East Grinstead for treatment, and have scans for five years.
“In 2022, I started to get large tumours on my leg, and I got upset every time I had it dressed. I remember the nurse, Bonnie, saying: “Margaret, I can understand why you get upset, because most people don’t see their tumours.” They just got worse and worse. I was sleeping on the sofa at home because I was so uncomfortable.
“Later that year, I went to see Les Miserables at the Marlowe Theatre with my daughter, Michelle. During the interval, I had to leave because I felt so unwell. A week later, I collapsed at home – I was just like a puppet. I called out to John, but he couldn’t get me up, so he phoned for an ambulance. I asked the paramedic to put me on the sofa and assured them I’d be OK, but they took my temperature and it was sky high, so they had to admit me to hospital, where I was diagnosed with sepsis. I was there for about a month, and I also caught COVID!”
Michelle added:
“Mum was discharged shortly before Christmas and was due to see her consultant around this time, but as she had been so unwell, I attended on her behalf. I explained what had happened, and the consultant was concerned. She said: “I can tell how ill your mum must be. I really think she needs palliative care, so I’m going to do a referral.” That was a massive shock; I came out of the appointment shaking. To me, palliative care meant Mum was at the end of life, on a downward spiral. But then things turned around very quickly; she was quite stable, and she started chemotherapy in January 2023.”
Margaret with her daughter, Michelle
Margaret continued: “They told me the chemo would be potent, could potentially make me very ill, and would cause me to lose my hair. On the whole, I was actually quite lucky; l didn’t feel sick at all and I pretty much sailed through the treatment. When I came out of hospital, they gave me a hospital bed at home, which made things a little easier. It was around this time that Pilgrims got in touch with me.”
Alongside pain management and symptom control, Margaret has benefitted from a range of wellbeing services at Pilgrims, including acupuncture and Wellbeing groups, through which she and other patients were involved in a musical theatre project with the Marlowe Theatre.
She also joins regular virtual meet-ups via Zoom, which offer an opportunity to connect with other patients from the comfort of their own homes.
In November 2023, John lost his balance and fell backwards at home, hit the back of his neck, severed his spinal cord and died within a week:
“Just like that. I couldn’t believe it; he’d been out cutting the grass that afternoon. He was 80. Since I’d been diagnosed, we’d always thought it was going to be me who went first – exactly a year before, when I was hospitalised with sepsis, it certainly looked that way.”
Pilgrims supported Margaret’s family through this very difficult time; her granddaughter, Holly, was offered counselling support as she struggled to cope with John’s sudden death.
Margaret was also invited for a Christmas meal at the Ashford hospice, where she could experience the environment in a relaxed, informal way.
She said: “I feel like everyone at Pilgrims is a friend, it’s a lovely community.
“I’ve got nothing but praise for the staff; they must see so many people, but they still know your name.
“Chatting with Palak from the Wellbeing team, I mentioned my love of singing and my interest in theatre, and she told me about a Hamlet-inspired project for patients that Pilgrims was facilitating with the Marlowe.
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Margaret took part in Hamlet workshops with the Marlowe Theatre at Pilgrims Hospice Canterbury
“When I was at high school, I had a marvellous music teacher – Mr Sellers – who saw my potential. He put me in every single play, and I even sung in Canterbury Cathedral. I was also part of the Young Marlowe Theatre Playgoers; we’d do readings and put on the odd play, but it was more of a training programme. It was completely free to attend, but in return, we would go to the Marlowe and give out refreshments to the actors.
“My best friend, Catherine, was also into the theatre. Her father offered to pay for both of us to go to the Italia Conti performing arts school in London, but my mum wouldn’t let me go. And because I couldn’t go, Catherine wouldn’t go – I messed up her chances, too! I still feel guilty about that!
“We used to have village shows in Wingham, and I always took part in those. I also sang in a band with John on guitar and our friend, Dick; we’d go out gigging round the local pubs, we had so much fun. Whenever Michelle and I go to the Marlowe now, I always say to her: “I wish that was me on the stage”.”
Margaret’s husband, John (second from left), playing with the band
In 2024/25, Pilgrims organised a musical theatre project with the Marlowe, open to patients, families, staff and volunteers, which helped Margaret to realise her dream. Workshops were held at the Canterbury hospice Therapy Centre, facilitated by local performers Tom Adams and Lillian Henry, with guest speakers from the Royal Shakespeare Company (RSC).
This culminated in the group writing and performing a song based around Shakespeare’s Hamlet, and a special event at the Marlowe in April 2025.
Margaret read a sonnet on stage and was invited to talk about her history with the theatre. She was also delighted to sit with an RSC representative during the event.
Margaret performing at the Marlowe Theatre in April 2025
She said: “I’m so touched that the RSC, and people like Tom and Lillian, will give their time to Pilgrims to create experiences like this for patients.”
Pilgrims continue to work closely with the Marlowe, and are planning another creative project in the near future.
Margaret added:
“Before I got involved with Pilgrims, I thought a hospice was a place you go to die. Now I know it’s so much more than that, and I tell everyone!
“I remember sitting in the Thanet hospice reception waiting for my acupuncture appointment. It wasn’t until my last session that I spotted the wards, which goes to show that hospices aren’t just beds on a ward.
“It’s totally different to what people think.
“Pilgrims don’t just offer end-of-life care, but also a whole range of wellbeing services and groups. It’s really opened my eyes.”
For more information on Pilgrims Hospices’ Wellbeing Programme:
Call the Pilgrims Hospices Advice Line on 01233 504 133
Each year, Pilgrims Hospices care for thousands of people across east Kent, with services provided from its three hospice sites in Ashford, Canterbury, and Thanet, as well as in patients’ own homes. It costs over £17.2 million annually to run these services, much of which comes from the generous support of the local community.
Each year, Pilgrims Hospices support thousands of people across east Kent who are living with life-limiting conditions.
Although hospice care is often associated with beds on in-patient wards, much of Pilgrims’ care takes place in the community – in people’s own homes, and in care homes.
Thanks to skilled, compassionate and dedicated community teams, Pilgrims is able to bring hospice care directly to patients who wish to remain at home, or in familiar surroundings, rather than be on a ward. This includes Hospice at Home, a team of Healthcare Assistants (HCAs) who attend to patients who are at the very end of their life and/or who have suddenly, rapidly deteriorated.
Jo Cottam, a retired NHS Senior Manager turned holiday let owner from Tenterden, experienced Pilgrims’ community care after her mum, Patricia Edwards, was diagnosed with vascular dementia. She shares how Pilgrims supported her mum and their family at the end of Patricia’s life.
Jo shares her story:
“In 2019, my mother was diagnosed with vascular dementia. She lived in a charming cottage on our property, spending her days with us in the main house and returning to her cottage at night.
In early July 2025, Mum’s health took a concerning turn. She stopped eating for about a week, drank less than we hoped, and lost her mobility, making walking (especially navigating steps between our house and her cottage) extremely difficult and distressing for her. My husband, Simon, and her carer, Steve, provided essential support, but we grew increasingly worried.
We decided to keep Mum in her cottage full-time, as moving her was too challenging. This meant constant supervision, as she couldn’t be left alone. Encouraging her to take fluids was a slow, painstaking process of syringing small amounts into her mouth. On 10 July, we called our GP, who visited promptly. He prescribed antibiotics for a possible UTI, end-of-life medications, and arranged a referral to Pilgrims’ Hospice at Home team.
Jo’s mum, Patricia
After a three-day course of antibiotics, Mum began to improve, slowly resuming eating and drinking.
Soon after, I received a call offering additional care support, which we desperately needed. Mum required physical assistance to move between her bed and sofa, constant prompting to eat and drink, and round-the-clock supervision.
Unfortunately, the caller later informed us that no additional care could be arranged immediately, though an equipment assessment was scheduled for the next day.
To our surprise and relief, that evening, two wonderful Hospice at Home carers, Jo and Sandra, arrived and said they would visit Mum twice daily. I was initially apprehensive, as Mum was used to familiar faces, but Jo and Sandra’s warmth and gentle introductions put her at ease. Mum smiled and co-operated fully, a testament to their kind and professional approach.
Over the next few weeks, every pair of hospice carers who visited showed the same compassion, treating Mum with dignity and respect.
They also supported our family, offering practical advice and emotional reassurance in overwhelming moments.
As a former Senior NHS Manager with over 25 years of experience, and with my husband, a retired Consultant Anaesthetist, we both recognise exceptional care when we see it. The hospice carers delivered first-class service.
We were astonished to learn they travelled significant distances to reach us in Tenterden, covering a vast geographical area. The team, led by the remarkable Mandy Hilden, exemplified dedication. Mandy’s hands-on leadership was inspiring – she never asked her team to do anything she wouldn’t do herself.
The carers went above and beyond, ensuring Mum was clean, dressed in her preferred clothes, and had her hair washed and styled. They made her laugh and calmed her anxieties, especially when she became distressed during repositioning, gently reassuring her even when she grabbed them in fear.
The rapport we built with the hospice carers in such a short time was extraordinary.
On 24 July 2025, Caitlin, a Palliative Specialist Care Nurse from Pilgrims, visited to assess Mum for potential future hospice care. Caitlin’s professional yet friendly demeanour brought smiles to Mum’s face. She patiently explained everything and answered our questions thoroughly. At the time, Caitlin was optimistic about Mum’s condition, believing hospice care wouldn’t be needed soon.
Tragically, on 29 July 2025, Mum passed away suddenly and peacefully at home, with us by her side, holding her hand. Caitlin, upon hearing the news, called to offer her condolences and support. Her kindness, taking the time to listen and guide me toward the hospice’s counselling services, meant the world during such a shocking and painful moment.
Pilgrims is an exceptional organisation, dedicated to supporting individuals with terminal illnesses, offering compassionate care in both community settings and specialised units. They prioritise the needs and dignity of each person, ensuring the highest quality of care during their final days.
Additionally, Pilgrims provides a nurturing environment for families, fostering support and understanding throughout the process.
The hospice team’s communication, care, and support for both Mum and our family were exceptional. We are immensely grateful for this vital service, which relies so heavily on charitable donations. Their compassion and professionalism made an unbearable time more bearable, and we cannot thank them enough.”
Pilgrims Hospices provides compassionate, specialist care free of charge to thousands of people in east Kent each year who are living with life-limiting conditions. Support is offered in patients’ homes, in the community, and at our three hospice sites in Canterbury, Thanet and Ashford. We also run a 24-hour advice line.
8th October 2025
Caring in the community: Stephen and Heather’s Hospice at Home story
When Stephen Coles looks back on the care his wife, Heather, received in her final months, he speaks with deep gratitude for the compassion and tenderness shown by the Pilgrims Hospices Hospice at Home team.
Heather, aged 64, had been living with Parkinson’s and Lewy Body Dementia. She died peacefully at home on 29 July 2025, with her husband by her side.
Heather
Heather had enjoyed a long and dedicated career at Benenden Hospital, where she worked for more than 25 years, most recently as Director of Infection Control, before retiring early due to ill health.
Stephen, who also worked at Benenden, cared for Heather at home in Ashford throughout her last year of life. As Heather became more frail and her needs increased, they were supported first by the Pilgrims community team, and later by the Pilgrims Hospice at Home carers.
Stephen and Heather met online in 2011, and their love story began soon after. They shared their first date at The Tickled Trout in Wye and, as Stephen fondly recalls, they both ordered the same meal of liver and bacon.
“I knew straight away she was the one for me,” he said.
As Heather’s condition progressed, their home was adapted to make caring for her easier, with a hospital bed moved into the downstairs room. Stephen stayed close by her side, sleeping nearby to offer reassurance and comfort.
Stephen and Hannah
Heather’s daughter, Hannah, was also a great support to both her mum and stepdad.
When the Hospice at Home team began visiting, Stephen immediately felt the difference their presence made:
“They didn’t just wash and care for Heather,” he explained. “They did so much more than I expected – washing her hair, tending to her so gently and with such kindness. I found their support really helpful for me, too. The level of care and commitment they showed was exceptional.”
The Hospice at Home team specialises in supporting patients and families at the very end of life, providing comfort, dignity, and peace at home.
Mandy Hilden, Team Lead, said:
“We know this is such a difficult time for those we visit, so we make sure we arrive with the right mindset to help both our patient and their family. We can’t make them better, so let’s make it the best end of life that we can.”
Hannah, a yoga teacher, added her own reflections:
“At first, there was an element of disappointment when we realised Mum was too poorly to be moved to the hospice. But we soon saw what the Hospice at Home team could achieve at home – it was extraordinary. The personalised, gentle care made such a difference. We all felt safe, like a weight had been lifted. There was no rush, just calm, attentive support.”
For Stephen, having the Hospice at Home team alongside them made Heather’s wish to remain in her own home possible, surrounded by love.
“After a difficult and tiring year, we were so pleased to have their support,” he said. “They cared for Heather so tenderly and were there until the very end. It gave us the chance to be with her at home, just as she wanted.”
He added: “Both Heather’s and my own children have been a tower of strength during these early weeks after Heather died. It has been a difficult time for us all, but I’ve felt it important to share the message about this very special element of Pilgrims Hospices care. The Hospice at Home team made Heather’s end-of-life journey as comfortable as possible, and we will always be grateful.”
Heather’s family chose a green burial with close family and friends, followed by a celebration of her life at Eastwell Manor, where Hannah teaches yoga. Almost 200 family, friends and colleagues came together that day to remember Heather and celebrate the life of a much-loved wife, mum and friend.
“It was a joy to be surrounded by so much love,” Stephen shared.
In Heather’s memory, the family set up a Facebook fundraising page, which has raised more than £1,400 so far, to be shared between Pilgrims Hospices and the Lewy Body Dementia support group – a lasting tribute to Heather’s life and legacy.
Each year, Pilgrims Hospices care for thousands of people across east Kent, with services provided from its three hospice sites in Ashford, Canterbury, and Thanet, as well as in patients’ own homes. It costs over £17.2 million annually to run these services, much of which comes from the generous support of the local community.
7th October 2025
Michael: “Pilgrims care makes me feel at ease”
Michael Taylor was diagnosed with liver cancer in 2015. Initially given a 5-year prognosis, he exceeded this, and continues to live well at home in Herne Bay with support from Pilgrims Hospices.
Born in Bromley, Michael was raised by his mother, Winifred, and many doting aunts and uncles. His father, John James Taylor, was a firefighter, but sadly died aged 28, when Michael was just three days old.
After marrying his wife, Brenda, the couple moved to Faversham and started their own family, welcoming three children – Helen, Paul, who sadly died of cot death aged 14 months, and Rachel – and now have five grandchildren.
Michael and Brenda on their 50th wedding anniversary
Michael was referred to Pilgrims in 2021 and attended Time to Create, therapeutic art groups that run at the Therapy Centres on each hospice site, offering relief from the challenges of living with a terminal illness. By then, Brenda had Alzheimer’s disease, but she was able to accompany Michael to the groups.
Michael said: “The Pilgrims team was extremely good; they sat and chatted with Brenda while I got on and did my own thing. I enjoyed it very much.
“The food was so lovely too, beautiful! Especially the cheese omelettes. We attended Time to Create for quite a long time, but it eventually got too much for Brenda, so I stopped for a few years.”
Michael enjoyed a long career as an architectural technician. Initially working in London and Kent, he eventually ran his own practice – Rowlett and Taylor – in Broadstairs with his colleague, Malcolm. He continued to draw, paint and build models into his retirement, so Time to Create appealed to his natural artistic flair. He credits Pilgrims with getting him back into his creative hobbies:
“After Brenda went into a nursing home, I had a phone call from Elizabeth in the Pilgrims Wellbeing team asking if I’d like to re-join Time to Create.
“Pilgrims provided a taxi for me, which was amazing. I hadn’t done any art or drawing, hadn’t touched a paintbrush or pencil or anything, in those two years since I’d stopped going. That phone call from Elizabeth got me right back into it; making art at Pilgrims again got me completely turned around.
“I’m a bit of a loner, so I had just been sitting in a chair for two years doing absolutely nothing, and now I can’t stop painting and drawing!”
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Michael’s artwork
Michael has been so well supported that he no longer feels he needs to attend the hospice Wellbeing groups, as Pilgrims has helped enable him to live comfortably at home. He does his own cooking, and has carers and a cleaner for extra support. He also enjoys visits from his children and grandchildren.
Michael now plans to attend his local Age UK group, which meets on Tuesdays, offering the chance to socialise with others and enjoy lunch together.
Michael continues to paint and draw, which is helping him to live as well and independently as possible. He recently sketched Herne Bay train station for his local model railway club, and is also a talented pianist; a church organist for 60 years, he now plays for his own pleasure.
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Michael Taylor Artwork 3
Michael Taylor Artwork 2
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Michael’s artwork
Although Michael doesn’t feel he needs Pilgrims at the moment, he knows he can access their support in the future:
“I’m not worried about death (can’t say I’m looking forward to it or wishing it was tomorrow!), but it doesn’t bother me because I have a strong Christian faith. I feel at ease, because if my health deteriorates, I can contact the hospice and go back into their care. Everybody I’ve met at Pilgrims is so kind – from the receptionists, to the catering and care teams, and everyone in between. They always make the time to sit and talk to me, even if they’re rushed off their feet.
“I would say to anybody who is in my situation – who is lonely and has lost interest – to ask Pilgrims about their Wellbeing groups, because I have found them really worthwhile. They get you out of yourself, and I’m so grateful to Pilgrims for inviting me to get involved.”
For more information on Pilgrims Hospices’ Wellbeing Programme:
Call the Pilgrims Hospices Advice Line on 01233 504 133
Each year, Pilgrims Hospices care for thousands of people across east Kent, with services provided from its three hospice sites in Ashford, Canterbury, and Thanet, as well as in patients’ own homes. It costs over £17.2 million annually to run these services, much of which comes from the generous support of the local community.
6th October 2025
Lily’s nursing journey at Pilgrims Hospices: “I’m lucky and honoured to be part of such an incredible team”
Lily Epps from Hythe was inspired to become a nurse after witnessing the care her mum, Ruth, received from Pilgrims Hospices when Lily was just 18 years old.
Initially training in Brighton, Lily moved home after six months and transferred to Canterbury Christ Church University to support her family after her mum died.
Lily shares why she chose to specialise in palliative care, and what she finds so rewarding about her role.
What drew you to palliative care, and why did you decide to work at Pilgrims Hospices?
Ruth and Lily
My mum was diagnosed with oesophageal cancer when I was 7; she was brilliant and resilient, and outlived an initial three-year prognosis by several years.
After conventional treatment and receiving the all clear, Mum went into remission and began experimental treatments. She worked closely with King’s College Hospital and took part in multiple trials; this fascinated me as I was growing up.
Unfortunately, the treatment didn’t work as we’d hoped, and Mum was referred to palliative care. I remember the Pilgrims nurses coming to visit her in our lounge, they always had an incredible aura of compassion. This really humbled me, and I wanted an opportunity to give back.
My mum always said it was the nurses who would make or break her day, and I strive to be a nurse that makes our patients’ days – especially in their final few days, when it is truly imperative.
I’m lucky and honoured to be part of such an incredible team at Pilgrims; everyone I work with is an inspiration, and so passionate about the care they give.
Lily Epps With Her Mum Ruth Epps 5
Lily Epps With Her Mum Ruth Epps 4
Lily Epps With Her Mum Ruth Epp 3
What does a typical day include for a Pilgrims nurse?
On the in-patient unit (IPU), we start the day with a cuppa to take to handover, which starts at 07:30am. One nurse takes charge and attends morning meetings which includes a whole multidisciplinary team (MDT) meeting, while a second nurse completes the morning medication round.
Depending on patients’ abilities, we’ll help our Healthcare Assistants (HCAs) to shower and bathe them. This is followed by a quick catch-up on the ward so that everyone is aware of any admissions or outstanding jobs, then we tag team going for a quick break before starting the lunchtime medication round.
In the afternoon, we update syringe drivers. We also complete pending discharge paperwork and give any medications needed. We focus on “what matters to me” for each patient, every day; this may be a very small goal, like having a bath, but it can completely change how they feel.
We always try our best to facilitate birthdays and wedding anniversaries. Our catering team provide beautiful cakes that can be enjoyed by families in the garden or in our lovely rooms. Even on long days, the evening quickly comes around, and we enjoy dinner before completing another medication round, settling patients, and handing over to the night staff.
What are the best things about being a nurse at Pilgrims?
Everything is amazing – including the food!
The whole team is incredible, from volunteers to social workers, wellbeing practitioners to consultants. It feels like a family. I’ve never worked anywhere so inclusive; everyone is so lovely, bubbly, down-to-earth and supportive. We all care about the patients and each other, which is clear on a daily basis.
I get more than seven weeks’ holiday per year, which shows how Pilgrims’ care and support extends to staff, too.
They also hold staff celebration days, and twice a year we’re offered therapeutic treatments like massage or reiki that fit around our working day.
What has your role involved and what have you learnt through working at Pilgrims?
I’ve learnt so much in my role at Pilgrims, mostly about different conditions, symptom control and treatment options. Every day is different. Most patients on the IPU come in for symptom control and usually stay with us for around two weeks, whereas the timeframe for our end-of-life patients varies.
I’ve worked with the Outcome Assessment and Complexity Collaborative (OACC) group. This is the collection of data used to measure, demonstrate, and improve the quality of palliative care for patients and their families by assessing clinical outcomes, symptom burden, and the complexity of care.
I also help the team to complete the Integrated Palliative Outcome Scale (IPOS)for patients. An IPOS allows us to integrate our care and ensure we aren’t missing anything, guaranteeing our patients are put first and that we continue to improve and meet their needs.
Do you have any favourite memories or anecdotes from your time at Pilgrims?
Simple things really bring me joy at Pilgrims.
Heart-shaped tattoo inspired by a patient’s legacy work
When patients come to us, they’ve often given up; they’ve been bed-bound and stuck inside for weeks. The light in their eyes when you say they can be wheeled outside on their bed and feel the sun on their face again leaves you with no words, and then there’s the cheeky smile when you offer a patient a beer or a glass of wine – these small things make working at Pilgrims so special.
We had an incredible patient who used to be a chef; as part of her legacy, she worked closely with our wonderful occupational therapy team to create a cookbook that is now sold on Amazon and can be shared with her children.
We helped a patient and her daughter do finger prints as part of the patient’s legacy work. The daughter got this as a tattoo in a heart shape, and her mum was able to see it before she died.
We helped to organise a patient’s birthday celebration in their room on the ward. She had two young sons, and one of them had his birthday shortly afterwards, so we did another celebration for him, too.
We decorated their mum’s room whilst she was showering, then surprised her and sang happy birthday; it was a beautiful moment.
A patient’s birthday celebration on the Ashford hospice ward
One patient, Celia, and her husband, Robert, celebrated their 50th wedding anniversary whilst Celia was in the hospice.
We’d had to remove Celia’s wedding ring because her fingers were swollen. I didn’t want that to be her memory of her final wedding anniversary, so I asked the kitchen to organise a surprise afternoon tea and help me set it up in the garden, and they whizzed up scones and finger sandwiches.
Celia had been bed-bound for a week, but she wanted to go outside, which we discovered via her IPOS (this is why they’re invaluable, and make the hospice so unique). We washed and dressed Celia, then carefully transferred her from her bed into the garden. Robert met us outside with the afternoon tea all set up and decorated just for them.
It’s such a happy place to work; no one wants their final days to be sad, humans are so resilient, and it’s humbling and inspiring being part of the hospice team.
Lily with Celia and Robert at their 50th wedding anniversary afternoon tea
Did you have any preconceptions about hospice care before you worked at Pilgrims?
I was lucky to experience the hospice as a visitor prior to joining the team, as I’d seen first-hand what a joyful environment it is.
People often have the misconception that hospices are all doom and gloom, but in reality they shine such a bright, positive light.
Of course there are hard days, but they bring the team closer together, as it’s such a supportive environment. There can be hard conversations, too, but you are supported to have them, with the opportunity to debrief afterwards.
Most patients understand why they’re here and just want to enjoy their final days, so it’s important to put them first and try make their wishes come true.
Why is hospice care important?
There is no greater privilege than supporting someone through the final days of their life. Pilgrims promote quality of life; we try our best to ensure patients don’t suffer, supporting them to die with peace and dignity. Although patients are our priority, we’re holistic in our approach; families are an extension of our patients, so when a patient dies, we continue to care for family members who need us.
The services that Pilgrims offer always melt my heart.
Stepping Stones is a bereavement support group run by the wonderful Annie Hogben, Expert Volunteer Development Lead, which is available to any adult living in east Kent, even if their loved one was not a patient of the hospice.
Another element I find so wonderful about Pilgrims is their legacy work; from hand casting and creating family trees, to voice recordings through the Blackbird Projectthat can be cherished forever.
This is all provided by the charity, which I think is truly incredible, and shows how unbelievably special Pilgrims is.
Pilgrims Hospices is currently recruiting for Registered General Nurses at our Ashford hospice.
Pilgrims Hospices provides compassionate, specialist care free of charge to thousands of people in east Kent each year who are living with life-limiting conditions. Support is offered in patients’ homes, in the community, and at our three hospice sites in Canterbury, Thanet and Ashford. We also run a 24-hour advice line.
