Care of the dying


Despite many advances in the care of dying people, there should be a huge welcome from healthcare staff and patients’ families for the introduction by the Irish Hospice Foundation of the Competence & Compassion, End-of-Life Care Map . Doctors and nurses face many challenges to retain both their compassion and competence in under-resourced emergency dDepartments where up to 12 per cent of hospital deaths occur, in areas such as intensive care units with about 20 per cent of hospital deaths, or in the wards where 68 per cent of patients die.

The document outlines simply how doctors can recognise when death is imminent, the complexities in breaking bad news, and the planning of end-of-life care with the essential recommendation that dying patients should be regularly offered opportunities for discussions on their prognosis, concerns, needs and wishes. It raises, too, a vital ethical issue: the importance of patient input, where the patient has capacity, into resuscitation or do-not-attempt resuscitation decisions.

This resource, which was developed in consultation with the HSE’s palliative care clinical care programme, follows the launch of another project aimed at improving the way we deal with the dying and their families. The Irish Hospice Foundation, with the assistance of recognised organisations, has developed an elearning training course for bereavement support groups and volunteers.

Up to 300,000 people are directly affected by bereavement each year and it has been long been recognised that the availability and standard of help services vary widely. Most grieving people can cope sufficiently with social networks, information and practical help with tasks. Some, perhaps 25 per cent, need more than that, but only 10-15 per cent will require professional intervention. This e-learning course will help clarify some of these issues. Its development also highlights the need for training and consistency in succouring people at a time of immense vulnerability.