If your friend or relative is living in their own home, NHS medical and nursing care is free of charge.

The GP has overall responsibility for the healthcare of ill people being looked after at home. A GP can:

• prescribe drugs
• organise nursing help if you need it: for example, visits from a district nurse or Macmillan or Marie Curie nurse, a physiotherapist or occupational therapist
• arrange for the person you are caring for to go into hospital or a hospice
• make arrangements for respite care.

If the person you are caring for has moved to your home from another area since they became ill, you will need to register them with your own surgery, or another local surgery. Let their old GP know what has happened, and register at the new surgery on their behalf. You will need the name and address of the previous doctor and, if possible, the person’s NHS medical card.

Contact the GP if you are worried about something: for example, a sudden change in behaviour or symptoms in the person you are caring for. The doctor may be able to talk you through the problem on the phone or make a home visit.

GP surgeries must provide a 24-hour service, although you may get through to a locum (temporary stand-in) doctor if you ring out of hours.

People who have ‘a continuing physical disability which prevents them from leaving home without the help of another person’ can get free prescriptions. Your GP or hospital doctor can give you an application form for a medical exemption certificate for the person you are looking after.

The district nurse (sometimes known as a community nurse) is a key person in the care of someone who is ill at home. They can visit regularly to give a range of nursing care, including giving drugs and injections, changing dressings, and giving advice on bowel problems and incontinence.

The district nurse can also arrange for special equipment to be delivered, such as:

• a commode
• a special mattress
• bedpans
• a hoist or sling.

They can show you how to do everyday nursing tasks such as washing, lifting and personal care.

The hospital should let the district nurse know that the person you are caring for is coming home, or the GP may arrange for them to visit.

The first home-visit you have will be from a district nurse who has overall responsibility for the nursing help you are given. They will discuss with you what care will be provided. After that, regular visits will be made by the district nurse. Usually, you will see the same one or two nurses.

District nurses can visit up to three times a day: morning, afternoon and evening, although this may vary depending on the services available in your area. Some areas also have night staff. Sometimes a nursing auxiliary will help the district nurse with things like bathing and washing. Your social worker can also organise help with bathing.

These teams are usually based in the hospital or hospice and may be called a palliative care team. They include specialist nurses (often Macmillan nurses) who work with the local community services to visit cancer patients being looked after at home. This type of support is often called ‘hospice at home’ and is intended to give many of the benefits of hospice care in your own home. They give advice to help control pain and other symptoms. Palliative care teams can also offer emotional support and advice on practical problems. As these teams are based in the hospital or hospice, they can often form a link between the home and the specialist nursing and medical services. If any problems arise, a member of the team can often get the necessary help quickly.

If you need extra nursing help, especially during the night when the district nurses don't visit, the hospital, GP, district nurse or a member of the home care team might suggest that a Marie Curie nurse visits you. Marie Curie nurses are trained to look after people with cancer. They specialise in giving practical nursing care and can spend the night or part of the day in your home, giving you a good night's sleep, or a break during the day.

The district nurse assesses the level of nursing care needed, but Marie Curie nurses are normally available during acute illness or the last few months of someone's life. The services of Marie Curie nurses are free of charge and are usually arranged through the local district nurse manager.

Macmillan nurses are also available to people with cancer. They specialise in pain and symptom control and in giving counselling and emotional support to patients and their families. The services of Macmillan nurses are free.

If the person you are looking after becomes incontinent (can no longer control their bladder and/or bowels), it can be very difficult for both of you, practically and emotionally. Your district nurse will be able to help you and may, in some cases, suggest a visit from a continence advisor. The continence advisor is a specialist nurse who can give advice on incontinence and information on aids and equipment to help cope with the problem.

Physiotherapists work for the health service. They are usually brought in by the GP, district nurse or home care team. They can help people who are ill to keep as mobile as possible. They also give help with pain relief and breathing exercises.

You may want to think about paying for private nursing. This is very expensive, and may only be practical as a short-term solution or if you are working, and it is essential there is a trained carer at home while you are out.

There are many private nursing agencies which can supply trained nurses to come into your home. Try to use an agency that has been recommended to you, or ask the local social services or a carers' or cancer support group for advice.