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.


What We Covered


What is complex care?

In brief, 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.

Complex Care definition: special care given to people who have long-term health problems and needs extra assistance with their symptoms and daily task

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 proficient in an array of specific caring methods. Dedicated training centers can teach and instruct these methods.

Carers should strive to facilitate patients in leading an independent and active life while also providing complex care. This can lead to a fulfilled life for the patient.

What does Complex Care mean?

Complex care means taking special care of people with many different health problems. These people might have long-term illnesses, disabilities, or a lot of health issues all at once.

Complex care involves a team of healthcare professionals working together to make these people healthier and happier.


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Types of Complex Care Needs and Their Providers

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

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

Let us highlight the correlation 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 a vital component of complex care, where 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 intricacies of various health conditions and the ability to provide patient-centered care.

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 to people with multiple health problems.

Nursing care includes various tasks, such as wound care, administering medications, monitoring vital signs, managing medical equipment, and providing skilled interventions.

Nurses play a pivotal role in assessing patients’ conditions, implementing treatment plans, and coordinating with other healthcare team members to optimize patient outcomes.

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

Rehabilitation therapy is a collaborative effort involving therapists, caregivers, and nurses, aimed at 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 personalized therapy plans.

Carers and nurses then assist in implementing these plans, providing support during therapy sessions, and ensuring 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, work collaboratively to ensure that patients’ end-of-life wishes are respected, and they can spend their remaining time with dignity and peace.

Care involves a lot and having the right skillset can greatly help

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Can carers provide complex 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 challenging for patients and their families to find carers with the experience required for individual complex care needs. Finding the right carer can be difficult for those seeking complex care.

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 high-quality 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. Firstly, the carer needs to be proficient in the complex care they are providing, to avoid any incidences, which could lead to inadvertent harm of the patient.

Secondly, by acquiring the knowledge to treat a complex care patient, the carer knows how to help the patient lead independent, active, and fulfilled lives.


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Communication in complex care

It is essential for good communication and coordination between the patient and the primary carer as well as between the carer and specialists.

This is particularly important during critical moments such as before procedures, new treatments and trips to the emergency room. Families can provide vital information as well.

As an additional note, there is often not enough communication between researchers and carers.

Carers should try to relay important information to researchers about management of both illness and patient care, helping them to develop ways to improve the independence of the patients’ life.

Tips for carers in complex care

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.

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.

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 annually. However, it gets them asking questions to each other and makes a huge difference.

Second opinions:

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.


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Bespoke Care may involve inserting catheters

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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.

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

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.

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 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.

blood for diagnosis

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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 evaluation to understand the individual’s health conditions and limitations.
  2. Goals and Objectives: Setting realistic and measurable targets to improve overall well-being.
  3. Medical Management: Detailing medical interventions, 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.

Unsure about the next steps? Our course advisors are here to provide you with expert guidance on your journey toward delivering exceptional care in care homes or nursing homes. Contact us at enquiries@caringforcare.co.uk or call 01782 563333 for personalised advice on your path to excellence in care.


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

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