Facilities and care for the terminally ill criticised

A STUDY of hundreds of facilities for dying people has criticised the lack of palliative care beds and the lack of privacy for people in their last days.

The study, jointly commissioned by the National Council on Ageing and Older People and the Irish Hospice Foundation, found that there are only 108 palliative care beds out of more than 20,000 in the hospitals system, a figure which the report described as "extremely low". There are none in acute hospitals.

It reviewed more than 500 institutions and interviewed 30 people who are nearing death along with 35 health professionals.

It found that the availability of private space for relatives and friends is "scarce in all settings" especially in acute hospitals where 40 per cent of people in Ireland die every year. Only 7 per cent of acute hospitals have an overnight room for visitors.

It found that only a third of acute hospitals have a bereavement officer/family liaison nurse to engage with families following bereavement and such support structures are also weak in the long-stay sector.

In addition to a shortage of palliative care beds, the report highlights a significant education and training gap in relation to palliative care provision.

The majority of care staff across all facilities have not received any formal qualifications in palliative care, with fewer than one-third of all facilities reporting that their qualified nurses held any form of post-registration qualification in palliative care.

The report said that routine visiting within long-stay settings from geriatricians, public health nurses and other health professionals was "very low" and was usually only provided when requested.

The report said it amounted to "the sequestration of dying people from living people by healthcare professionals".

Speaking at the launch of the report yesterday, Dr Ciarán Donegan, the chair of the National Council on Ageing and Older People, said that the study raised the question of the value placed by Irish society on how its older members are supported and cared for at the end of their lives.

"The process of dying is reflective of broader social values and the study findings suggest that neglect of end-of-life care for older people is indicative of ageist attitudes in our society," he said.

The chair of the Irish Hospice Foundation, Denis Doherty, said the recent interview with Nuala O'Faolain, who is terminally ill with cancer, illustrated the need for greater sensitivity towards people who are dying.

Labour health spokeswoman Jan O'Sullivan said the report was a "sad reflection" on the priority palliative care had for the HSE. "The picture this report paints is of terminally ill people having to share rooms, where their families have little or no recourse to bereavement counselling, and where pain management services are at best patchy," she said.

The HSE said it had provided €17 million over the last three years for palliative care beds and it was in the process of putting together a five-year palliative care services development plan.