HealtH Matters 93
HospiCe Care
policies, suitability of morgues, procedures are currently funding four pilot projects
and end of life care. already substantial to enhance palliative care for people with
changes are being made, most notably in “irish Hospice Foundation advanced heart or respiratory failure, and
communications. How do we tell patients
they are dying?
staff members have
dementia). as is clear in Palliative Care for
all – Integrating Palliative Care into Disease
the audit itself relates to patients who
been co-operating with
Management Frameworks (IHF 2008) –
died in Irish hospitals in 2008/9, based on palliative care should be provided on the
questionnaires completed by nurses and hospitals in assessing basis of need, not disease.
doctors. these deaths are a representative
sample of 10 per cent of annual deaths. It
their bereavement
Our grants programme for innovative
projects and research, the Msc/
is encouraging that in many respects, the
policies, suitability of
postgraduate diploma in bereavement
quality of end-of-life care in Irish hospitals studies, the certificate in children and
compares favourably with that reported in morgues, procedures and loss, and training on aspects of loss and
other jurisdictions.
However, despite this relatively positive
end of life care. already
bereavement are always integral to our
work. We will also continue to support night
picture there are some issues needing
substantial changes are
nursing for non-cancer patients.
deep analysis. One issue is that doctors Most importantly, we will continue to
and nurses can disagree on pain levels and being made.” promote good hospital design and dignity
their frequency. they can also have different standards and quality standards for end of
views on the acceptability of how patients life care.
died. Doctors and nurses agree that they With all of this work, in cooperation with
are better at communicating with relatives with life-limiting conditions at home. the statutory and other voluntary agencies,
rather than their patients. Meanwhile we will continue to support Ireland one day can claim that no one has
the Irish Hospice Foundation also the extension of hospice care to all to face death or bereavement without the
recognises that while patients in some areas patients with life-limiting conditions (we appropriate care and support.
of the country can access comprehensive
services, other areas suffer serious under-
provision. More palliative care beds are
needed, as indicated in the Government's
five-year development framework. But
this need not be a financial drain. It can
come about within the reconfiguration
process underway within the Hse. this
would involve reallocating beds and staff
to palliative care without adding to the total
number of state funded beds.
Indeed, while ethics and quality of care
is our compass needle, it is relevant to
stress that international evidence supports
the view that palliative care is cost-effective
and can help the state save money.
Patients who use palliative care have fewer
admissions to acute hospitals, shorter stays
and quicker discharges.
It is time for innovative thinking. We
must have increasing co-operation
between the IHF, the Hse, and the DOHC.
encouragingly this is coming about under
our new five-year programme to develop a
hospice home care service for children. this
will oblige the IHF to fundraise more than
c3 million to pay for Ireland’s first Paediatric
Palliative Care Consultant as well as five
of eight outreach nurses: they will provide
support and co-ordinate care to children
HM Iss6.1 p71-128.indd 93 12/03/2010 15:26:56
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