Renewed call for consistent end-of-life services nationwide

Categories: Policy.

The push for equal access to best quality palliative and end-of-life care across Ireland is outlined in the Irish Hospice Foundation’s Strategic Plan for 2016-2019.

IHF chief executive officer Sharon Foley said existing services are “inconsistent” and everyone should have equal access to the end-of-life services they require according to their needs.

The Midland counties of Laois, Offaly, Longford and Westmeath have been pin-pointed as end-of-life care “blackspots”.  The IHF wants to ensure everyone can access quality end-of-life care – no matter where they live.

The IHF said it is simply not good for a modern society that the area in which you live in dictates where you die.

The IHF said equitable access to palliative care is a strategic concern for the Irish health service but claims national policies have been implemented unevenly and gaps remain

The IHF strategic plan said existing palliative care services are stretched. It is harder to access services with a diagnosis other than cancer.

The IHF said the 283,000 strong population of Longford, Westmeath, Offaly and Laois do not have the range and volume of end-of-life services available to people in other regions such as the neighbouring mid-west.

While it acknowledges that existing services are “excellent” it pointed to key shortages in hospice homecare services at local county level, in all acute hospitals, hospice outreach and day care.

The IHF said “most importantly” there is no specialist inpatient hospice – also known as Level  111 Hospice to support and enhance services in Laois, Offaly, Longford and Westmeath.

At present patients with complex needs in these Midland counties have no option other than to be admitted to an acute hospital for care, often through a busy emergency department.

It means that many more people die in the acute hospital. The IHF said double the percentage of people with cancer who die in the Midlands die in an acute hospital compared to areas where there is a specialist in-patient hospice.

Sharon Foley said: “We also think there needs to be more training for staff in end-of-life bereavement and palliative care. It’s not widespread and it’s not consistent. If we want the best end-of-life care to be delivered throughout Ireland, you have to support staff.”

The IHF will continue to campaign at HSE and Government level to get additional end-of-life services where gaps exist.

Ms Foley  said the IHF is delighted to see a very strong commitment to palliative care in the recent Programme for Government.

She said: “We think bereavement is inadequately addressed in Ireland. The forthcoming National Palliative Care Framework makes a commitment to the development of standards and we really welcome that.

Each year in Ireland 29,000 people die. It’s estimated that 10 people are directly affected by each death.

Most people – 75 per cent – said they wanted to die at home when asked in recent research. However only about a quarter of people actually do die at home. A similar number of people die in nursing homes.

Most deaths – 43 per cent – take place in hospitals. Six per cent of deaths take place in a hospice.

IHF chairwoman said Jean McKiernan said : “The vision of the IHF is that no one will face death without the care and support they need. Our mission is to strive for the best care at the end of life for all. There is only one chance to get dying, death and bereavement right. We believe that everyone has the right to be cared for and die with dignity and respect in the care setting of their choice.”

The IHF launched a campaign to highlight the gap in end-of-life care services in the Midlands at the end of 2015. It is calling on Government and HSE to boost services in the region.

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