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 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.

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.

What is complex care in nursing and who is a complex care nurse

What is complex care in nursing and who is a complex care nurse?

Complex care nursing is helping patients with very tricky health troubles needing specialist management and tailored care.

A complex care nurse is a senior registered nurse with extra training. They coordinate care for people living with multiple lifelong, critical or end-of-life illnesses.

What complex care nurses typically do:

  • Fully assess medical history, family, medications, symptoms
  • Develop custom care plans for health, self-care, food, comfort
  • Closely track confusing changing symptoms
  • Communicate often with many specialist doctors
  • Teach patients and families about complicated conditions and home care
  • Organise community aids and services after hospital discharge
  • Give treatments, tests and pain relief care per doctor orders
  • Update care plans continually as someone’s needs change

In essence, complex care nurses lead very specialised one-on-one care. They understand intricate diseases that keep getting worse.

This means skilfully coordinating all the care pieces, and adjusting plan details as someone’s health fails or they near end of life.

Their support means more stability for coping with confusing long lasting or end-stage situations.


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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.

Common recipients of complex care services include:

  • Elderly people dealing with multiple ongoing illnesses or flare ups
  • Adults with major diagnoses like organ failure or advanced cancer
  • Survivors of big health emergencies like strokes requiring long stabilisation
  • Children with inborn issues, genetic disorders or permanent injuries
  • Those needing breathing machines, feeding pumps or waste removal
  • People pursuing end-of-life comfort care
  • Anyone taking loads of prescribed meds that need monitoring
  • Bedridden or highly immobile people progressively losing abilities

Complex care aims to give the best possible daily life for those managing tough home health situations.

It offers very personalised nursing to keep the person hopefully stable, peaceful and safer at home despite increasing problems.

This care means helping families cope with mounting losses or disabilities while still finding a reasonable quality of life. It brings comfort when getting completely better remains unlikely.

Definition of complex care needs which is the health and daily help required by a person living with multiple major long-lasting medical issue

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:

Medical Needs

  • Life-sustaining treatments like dialysis or oxygen therapy
  • Chronic symptom management like constant pain or nausea
  • 24/7 tracking of serious vital sign changes
  • Many interacting meds and treatments

Daily Living Help

  • Disability assistance with bathing and toileting
  • Rehab for loss strength, mobility or movement after critical injury/illness
  • Regular moving to prevent severe bed sores
  • Feeding tube use if unable eat adequately

Emotional and Life Needs

  • End of life care services for ultimately terminal diagnoses
  • Counselling, breaks for daily caregivers and home equipment over years of illness
  • Help getting access to unavailable health services and benefits

In essence “complex care” means substantial nursing, daily living support and case coordination for serious long term diseases.

It aims to improve comfort through help tailored to managing the best possible daily life at home.

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 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.

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

“Caring is the calling, and kindness is our language.” 💖

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 difficult 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 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. Firstly, the carer needs to be so good in the complex care they are giving to the patient, 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.


WE PROVIDE BESPOKE COMPLEX CARE TRAINING TO ORGANISATIONS – GET DETAILS HERE


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

1. 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.

2. 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.

3. 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.

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.



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.

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.



blood for diagnosis and transfusion. Someone receiving a or donating a blood

“Every act of care creates a ripple of hope in someone’s heart.”

What are advanced care needs examples?

Complex needs mean dealing with many connected challenges that people may face.

It requires special and complete support to help with things like physical health, mental well-being, and social factors.

Here are some examples of advanced care needs:

  1. Brain Issues: Conditions like stroke, head injuries (TBI), multiple sclerosis, and Parkinson’s disease can bring various challenges, needing special support for physical, thinking, and emotional difficulties.
  2. Special Learning Needs: People with conditions like autism, learning disabilities, and Down syndrome might need extra help with communication, social skills, and daily activities.
  3. Long-Term Health Problems: Those with multiple ongoing health problems like diabetes, heart issues, and lung conditions may need careful management to stay healthy and avoid complications.
  4. Serious Mental Health Troubles: Individuals facing severe mental health problems such as schizophrenia, bipolar disorder, or major depression might need a mix of medication, therapy, and social help.
  5. Older People: Seniors dealing with challenges related to getting older, mobility problems, and health issues may need special care to stay independent and well.
  6. Trauma Survivors: People who’ve been through significant physical or emotional trauma, like accidents, abuse, or disasters, might need a lot of support to cope.
  7. Substance Use Problems: Those dealing with substance abuse or addiction might need a mix of medical help, counseling, and social services to recover.

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.
Benefits of providing complex care training which are improve staff capability, quality of care for patients, personal-centered care, addresses the demand for complex care staff

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 organization 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.


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


Benefits of providing complex care training

What are the benefits of providing complex care training?

Patients with complex care needs require staff that understand their conditions and can provide the appropriate and necessary care.

Providing staff with opportunities to develop and train can have a significant impact on their ability to do their job.

Additionally, it can positively influence the way they feel about their job.

Confident employees will carry out their roles professionally. The training they have undertaken can empower them to provide quality care to their patients.

The quality of life for patients is an essential part of the health care sector.

Staff who have trained and developed in their careers can offer patients a better quality of service.

Care providers must give staff the opportunities to develop their careers, particularly in complex care, as a quality care service is an essential aspect of the healthcare industry.

The complex care area of healthcare is becoming more common, requiring staff to be trained to deal with the conditions, disorders, and patients.

Training can take many forms, both face-to-face and online courses, to equip staff with the necessary skills and knowledge to deal effectively with the complex care needs of their patients.

Highly skilled staff with specialist training allows healthcare providers to offer better care to patients.

Staff should be trained to deal with the wide-ranging conditions that fall under complex care, as it is particularly relevant in this area of healthcare.

In Addition

Complex care will be a constant in the health care sector for many years to come, due to the growing population, the increased life expectancy of individuals and the complex nature of health.

Enabling staff to train and develop their careers will ensure the need for properly trained healthcare professionals, resulting in high staff morale and the provision of professional and patient-centered care.

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.

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.


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/

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