Complex Care

Complex care is usually provided to individuals by a team of healthcare professionals, including nurses, doctors, therapists, social workers, and case managers. They all work together to develop a care plan that meets the individual’s unique needs.

According to Sense 2022 post, there are over 1.6 million people with complex disabilities in the UK.

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What is complex care?

Complex care, also known as long-term care or continuing care, is given to patients with significant, continuing healthcare issues such as chronic illness and disabilities that can arise after receiving hospital treatment.

In simple terms, complex care is a special kind of healthcare and support given to people who have chronic or long-term health problems and need extra assistance with their symptoms and daily tasks.

Examples of complex care needs are neurological disorders, developmental disabilities, chronic health conditions such as diabetes and heart disease, substance use disorders, and mental health disorders.

Complex care can be provided either at home or in a residential nursing home, depending on what the patient likes.

These healthcare issues could include brain damage, spinal cord injuries, multiple sclerosis, muscular dystrophy, ventilators, Gastrostomy feed needs such as PEG, Epilepsy, and learning disabilities.

Complex care requires the carer to be skilled in a range of specific caring methods. Dedicated healthcare training centres can teach and guide carers in these methods.

As a carer, you should help patients live independently and stay active while providing complex care. This way, they can enjoy a more fulfilling life.

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Who is complex care for?

Complex care is for patients facing ongoing, serious, or end-of-life health conditions. It involves skilled nursing supervision and coordination among various medical experts.

People who receive complex care services include:

🔹Older adults with ongoing health issues
🔹Adults with serious conditions like organ failure or cancer
🔹Survivors of major health events, like strokes, who need long-term care
🔹Children with birth defects, genetic disorders, or lasting injuries
🔹Those using breathing machines, feeding pumps, or needing help with waste
🔹People needing comfort care at the end of life
🔹Anyone on many medications that need checking
🔹Bedridden or very immobile individuals losing abilities

The essence of complex care is to give the best possible daily life for those managing tough home health situations.

What are Complex Care Needs?

Complex care needs refer to the health and daily living help required by a person dealing with multiple major long-term medical issues.

Some examples of needs:

Types of Complex Care Needs and Their Providers

The type of complex care given to a patient would vary based on the patient’s unique needs.

It is important to consider the contributions of different health professionals and their roles in supporting patient well-being and quality of life.

Let us highlight the similarities between the specific complex care needs of patients and the corresponding health professionals required to address those needs effectively:

1. Personal Care (Provided by Carers/Home Health Aides)

Personal care is an important aspect of complex care. Caregivers or home health aides provide hands-on assistance with daily living activities for individuals with physical or cognitive limitations.

These dedicated professionals offer support with essential tasks such as bathing, dressing, grooming, toileting, and mobility assistance.

They play a crucial role in helping patients maintain:

• their independence,
• promoting their dignity, and
• ensuring their comfort in their own homes or care facilities.

2. Nursing Care (Provided by Nurses)

Nursing care is a fundamental aspect of complex care, delivered by registered nurses (RNs) or licensed practical nurses (LPNs).

These skilled professionals are responsible for the clinical management of patient’s health conditions.

Complex care within nursing requires a deep understanding of the mix of various health conditions. Also, the ability to provide patient-centered care is necessary.

In addition, complex care in nursing is all about making sure that healthcare professionals work together as a team and communicate well to give complete and thorough care.

Nursing care includes various tasks, such as:

• wound care,
• administering medications,
• monitoring vital signs,
• managing medical equipment, and
• providing skilled interventions.

Nurses play an big role in assessing patients’ conditions, implementing treatment plans, and coordinating with other healthcare team members to optimise patient outcomes.

3. Rehabilitation Therapy (Provided by Both Carers and Nurses)

Rehabilitation therapy is a collaborative effort involving:

• therapists,
• caregivers, and
• nurses,

The aim of a rehabilitation therapy is towards restoring or enhancing a patient’s functional abilities after an illness or injury.

Physical therapists, occupational therapists, and speech-language therapists work closely with patients to design personalised therapy plans.

Carers and nurses then assist in implementing these plans and providing support during therapy sessions. Also, they ensure patients adhere to exercises and treatment protocols for optimal progress.

4. Social Support (Provided by Social Workers or Mental Health Professionals)

Social support is a crucial aspect of complex care, facilitated by social workers or mental health professionals.

These professionals offer emotional and psychological assistance to patients and their families facing the challenges of living with chronic conditions.

They provide:

• counseling,
• guidance, and
• resources to help individuals cope with stress, depression, anxiety, and other emotional aspects of their health journey.

Social support aims to improve patients’ overall well-being and enhance their ability to manage their health effectively.

5. Hospice Care (Provided for End-of-life Support)

Hospice care is a specialized form of complex care provided to individuals in the final stages of a terminal illness.

The focus of hospice care is on:

• providing comfort,
• pain management, and
• emotional support to patients and their families during this difficult time.

Hospice care teams – comprising doctors, nurses, social workers, and spiritual counselors. This healthcare workers work together to ensure that patients’ end-of-life wishes are respected.

This is also to ensure patient can spend their remaining time with dignity and peace.

Can Carers provide complex care?

The role of a complex carer is to give full support to people with several serious health needs.

They manage care, handle medications, help with daily tasks, and work with healthcare professionals to provide complete and personalised care.

Carers can provide complex care to patients but, as mentioned above, they need to be proficient in specialist care techniques.

These could include enteral/PEG feeding, stoma care, gastrostomy feeding, nasopharyngeal suctioning, oral suctioning, bowel management, oxygen therapy and tracheostomy care.

It can be difficult for patients and their families to find carers with the experience required for individual complex care needs. This is even more evident due to the aging population in the UK and the shortage of health workers.

This is why training centres, like Caring for Care, are so important. We provide the training that is necessary in order for carers to deliver better care for individuals with complex care requirements.

The needs of individuals dictate the type of complex care a carer needs to provide and therefore the type of training they need to undertake.

This is important for two reasons:

1️⃣ Firstly, the carer needs to be scompetent in delivering exceptional care to the patient, to avoid any incidences, which could lead to unintended harm of the patient.

2️⃣ Secondly, by acquiring the knowledge to treat a complex care patient, the carer knows how to help the patient live independently – active and fulfilled lives.

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Related Courses – Comphrensive CHAPS Training For Nurses and Carers

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4 Important Tips for Carers in Complex Care Roles

1️⃣ Use a care plan:

This is a summary of a patient’s history, medication, doctors names and other vital information that can be used by a carer who is taking the patient’s case for the first time in order to learn as much about them as possible. This gives credibility to your service as a carer.

2️⃣ Medication and symptom record keeping:

This is a must and records should be kept over long periods. The importance of this is to help to communicate this information to doctors and other members of the care team.

3️⃣ Multidisciplinary meetings:

These are a great way to get specialists together to talk about the patient. They don’t have to occur regularly, perhaps only every year. However, it gets them asking questions to each other and makes a huge difference.

4️⃣ Getting second opinion:

It’s always best to get second opinions from doctors and other carers.

If a patient’s family asks for a second opinion, don’t be offended. They are only trying to do what is best for their loved one.

Types of complex care

To understand the importance of proper training for complex care, here are some examples of types of complex care, what they are.

Additionally, possible problems that might arise should also be considered.

1. PEG (Percutaneous Endoscopic Gastrostomy)

Percutaneous Endoscopic Gastrostomy, or PEG for short, is a type of complex care provided to individuals who require enteral nutrition due to the inability to maintain adequate nutrition via oral intake.

This can occur for several reasons, in particular, acute ischaemia, chronic progressive neuromuscular diseases, dementia, cystic fibrosis, peritoneal dialysis and oropharyngeal and oesophageal malignancy.

In children, common reasons include neurological disorders, craniofacial abnormalities, oncological problems related to malnutrition, and chronic kidney disease along with other clinical conditions that cause wasting or malnutrition.

As with all types of care, there are contra-indications to PEG such as active coagulopathies, thrombocytopenia, haemodynamic compromise or sepsis.

Undergoing PEG Feeding training will cover these and allow the carer to carry out complex care in this area.

2. Stoma Care

An opening to which ostomy bags are attached is called a stoma. Stoma care is provided to individuals who require them.

Examples of ostomies include colostomy, ileostomy, urostomy and gastrostomy.

Patients may need these bags for various disorders such as inflammatory bowel disease, invasive neoplasia of the bladder or prostate, and diverticular disease.

Patients use the bags to manage output from a surgically created stoma, which can be temporary or permanent.

Stomas come with many associated problems and manifest as both psychological and physiological issues. Stoma patients commonly experience anxiety and depression.

A decrease in quality of life, body image issues, and “phantom rectum” sensation can cause anxiety and depression in stoma patients. Stoma care training involves considering many factors, such as dehydration, skin problems, changes in feces, and bleeding.

3. Tracheostomy care

When understanding tracheostomy care, the first thing you should consider are the two main types. These are acute tracheostomies and chronic tracheostomies.

Chronic tracheostomy is applied to long-term patients, whereas the first type is applied in an emergency.

Complication can arise at any point during the process including immediately after and in the early and late stages.

When you undertake tracheostomy care training, you will learn about haemorrhages, hypoxia, oesophagus damage, pneumothorax, tube obstruction, pooling of secretions, LRTI, bleeding, infection, airway obstruction, tracheal stenosis, and tracheomalacia.

The trainers will also introduce you to some other complication Stoma care is also important with tracheostomy patients, as is tracheostomy tube care, communication, humidification, swallowing and nutrition, and suctioning.

4. Palliative Care

Palliative care is an essential part of quality complex care. It focussed on relieving suffering and improving comfort for those with serious advancing illness.

Palliative care training lets nurses deliver pain relief, symptom control, emotional support and decision assistance as disease progresses from chronic to end stage.

Specifically, palliative skills for complex care nurses involve:

Pain Management

• Administering opioids safely via IV, patches, epidurals etc
• Increasing or reducing dosages to match pain levels
• Adapting approaches as pain changes

Full Symptom Control

• Managing nausea, tiredness, insomnia, swelling beyond only pain
• Coordinating bowel regimens, special diets, mobility aids

Emotional Guidance

• Counselling patients and family members on grief, anxiety, denial, depression
• Clarifying priorities aligned with personal values and lifestyle needs
• Discussing practical issues around death (financial, funeral)

Sensitive Communication

• Having open yet kind conversations on decline, life expectancy, death
• Explaining all care options to support informed choices

This specialist training provides knowledge so complex care nurses can champion whole-person healing – maximising possible function and comfort using all feasible means at each stage ahead.

It promotes dignity until the closing chapters of life.

5. End of Life Care

End of life care is a key part of complex care. It focusses on relieving suffering and improving comfort in a patient’s last phase of life.

End of life care training lets nurses expertly deliver pain relief, prepare families, guide tough decisions, and create meaningful last moments.

Specifically, end of life skills involve:

Pain and Symptom Management

• Safely increasing doses of strong pain medications to stay ahead of worsening pain
• Managing all symptoms on top of pain – swelling, breathing struggles, seizures

Supporting Family

• Making space for family time together – sharing memories, rituals
• Giving bereavement counselling on expected grief, denial, regret

Practical Assistance

• Clarifying wills, financials, funeral plans with patient and relatives
• Adapting the home setting for safe, peaceful dying

Advocacy and Listening

• Discussing care choices honouring what matters most to patient
• Ensuring patient voices and wishes are fully heard by all involved

This training provides expertise according to a research so nurses can promote holistic healing of the heart and soul – finding meaning via music, validating years of lived life, empowering tiny joys amidst sadness.

It affirms life until the very end.

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Related: Personal Health Budget – What are they and how can they help?

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Major Components of a Complex Care Support Plan

A complex care support plan is a detailed document tailored to an individual’s specific needs and challenges.

The major components include:

1. Assessment and Diagnosis: Thorough check to understand the individual’s health conditions and limits.
2. Goals and Objectives: Setting goals that can be done and can be measured to improve overall well-being.
3. Medical Management: Detailing medical help given, medication management, and monitoring of chronic conditions.
4. Therapy and Rehabilitation: Outlining therapy types to enhance functional abilities and independence.
5. Mental Health Support: Including counseling and therapy for emotional well-being.
6. Social and Community Support: Identifying resources for social engagement and community involvement.
7. Caregiver and Family Support: Involving and supporting caregivers in providing care.
8. Education and Training: Providing information and training for self-management.
9. Communication and Collaboration: Ensuring effective teamwork among healthcare professionals.
10. Emergency Care Plan: Instructions for handling medical crises.
11. Periodic Evaluation and Updates: Regularly reviewing and updating the plan for relevance and effectiveness.

How can complex care training benefit care providers?

Investing in staff development can lead to enhanced reputation for care providers. Complex care training benefits also includes quality of care provided to patients.

Training staff is crucial in reducing the risk of accidents and injuries. It equips them with the necessary knowledge and skills to handle complex care needs effectively.

Providing training for staff also has a long-term impact on businesses.

Development opportunities and routes for progression are provided to give staff the option to further their careers. These opportunities help them to feel valued in a supportive work environment.

By investing in the development of staff, providers can attract and recruit talented employees, and most importantly retain them.

Attractive career opportunities are important in attracting health care professionals. A focus on training and development is also crucial to make an organisation an appealing place to work for them.

Care providers must ensure that their staff are trained in line with laws and professional standards that must be adhered to.

The health and social care service regulator, The Care Quality Commission (CQC), requires staff to receive ‘appropriate training’ and take part in a full induction before they start work.

This highlights the importance of providing adequate complex care training for staff to ensure they can provide the best possible care to these patients.

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Related post: How good quality health and social care training will benefit your care workforce

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How can care providers ensure that the care they provide is effective?

Care providers have a significant responsibility in the lives of people with complex disorders. They are responsible for caring and supporting those individuals on a daily basis.

Health care professionals need to build strong relationships with patients.

This can be achieved by providing needed training for health care workers in both aspects of complex care and emotional support provision to patients and their families.

Addressing the Demand for Complex Care Training

Complex care is becoming more common, so healthcare providers need to train their staff to handle these challenging cases.

Providing training opportunities for staff can significantly impact their ability to provide quality care and positively influence their job satisfaction.

Key Benefits of Complex Care Training for Staff:

1. Enhanced Skills and Knowledge: Training equips staff with the expertise to understand and manage the complex needs of patients.
2. Improved Job Performance: Confident and skilled staff are better equipped to carry out their roles professionally, leading to improved patient outcomes.
3. Increased Job Satisfaction: Staff who have access to training opportunities and feel empowered to provide quality care experience higher levels of job satisfaction.
4. Enhancing Patient Care Quality: Well-trained staff can provide comprehensive and patient-centered care, contributing to better patient outcomes.
5. Addressing the Growing Demand: The increasing prevalence of complex care necessitates a well-trained workforce to meet the demands for quality care.

Training Delivery Options:

1. Face-to-Face Courses: Traditional face-to-face training allows for direct interaction with instructors and peers, fostering a collaborative learning environment.
2. Online Courses: Online training offers flexibility and convenience, enabling staff to access learning resources at their own pace and from anywhere with an internet connection.
3. Hybrid Approaches: Combining face-to-face and online training methods can provide the best of both worlds, maximizing flexibility and engagement.

Empowering Healthcare Providers:

1. Enhancing Staff Skills: Complex care training equips staff with the necessary skills to meet the evolving needs of patients.
2. Addressing the Complexity of Care: Training provides staff with the ability to navigate the intricacies of complex care scenarios.
3. Providing Patient-Centered Care: Well-trained staff can deliver compassionate and individualized care, meeting the unique needs of patients.
4. Meeting Future Demands: Complex care is expected to increase, and training ensures healthcare providers are prepared to meet these challenges.

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Unsure about the next steps? Contact us at enquiries@caringforcare.co.uk or call 01782 563333 for personalised advice on your path to excellence in care.

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Conclusion

As you can see just from reading briefly about specific examples, complex care is very complex. Trained carers should be the only ones administering it for this reason

Here at Caring for Care, we provide carers with the required training necessary to carry out complex care. If you would like to learn more about our complex care training options please visit this link.

Alternatively, why not call us on 01782 563 333 and speak to our friendly and knowledgeable staff.

References

Trinity Homecare – http://www.trinityhomecare.co.uk/resources/blog/complex-care/complex-care-faqs/

PA Care – http://www.pa-care.co.uk/complex-care/

Prestige Nursing Care – http://www.prestige-nursing.co.uk/nursing-care-services/care-at-home/complex-nursing-care/

Patient – http://patient.info/doctor/peg-feeding-tubes-indications-and-management

Mental Health: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8903266/

Parkinson’s Disease: https://www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptoms-causes/syc-20376055

End of Life Care Education: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10070522/