New report highlights how end of life care in Ireland could be improved

Categories: Policy.

A good death; a reflection on Ombudsman complaints about end of life care in Irish hospitals’ reviews complaints made to the office in 2013.

Almost every case in the review, and most of those that come to the Ombudsman, arise because of poor communication at some level and lack of clarity about the respective duties and rights of doctors, nurses, patients and families or friends.

Ombudsman Peter Tyndall hopes that his report will help those involved in caring for people who are dying to learn from mistakes others have made and promote best practices in end of life care.

Speaking at the launch, he said: “I hope these real life experiences will make a positive contribution to the national debate on end of life care and the campaign to make Ireland a good place to live in and to die in.”

In one case included in the report, which highlights the necessity of clear communication, neither patient nor family was informed of how seriously ill the patient was. The family bitterly regretted that this news had not been shared with their mother or themselves. The daughter said, “We should have been given the truth that would have allowed us support and assist her in coming to terms with her prognosis in the last few weeks of her life. Instead we were trying to get her to eat and giving her hope.”

Another case highlights the need for support for families and carers of those who are dying, which is key if patients are able to spend their last days at home. The family brought their 85-year-old mother home to care for her when she was dying but they were not told how to administer morphine. There was confusion over how the medication was to be sourced and the family had to call a GP in the middle of the night to provide essential pain relief. It was a bad experience for the woman and left a crippling memory for her family. 

The report also quotes one woman who stressed the importance of learning from mistakes: “It gives me great peace of mind that my complaint will lead to changes in practice and hopefully deter such poor standards of care occurring again.”

In concluding the report, the Ombudsman commends the Irish Hospice Foundation, the Hospice Friendly Hospitals Programme, and all other public and voluntary organisations who strive to provide excellent care for people at the end of their lives.