There has been a significant increase in demand for the Irish Cancer Society’s night nursing service during the Covid-19 pandemic, mostly due to visiting restrictions in hospitals, nursing homes and hospices.
Central Statistics Office (CSO) figures show that between October 2019 and last September the number of death notices published on RIP.ieciting 'home' as the place of death increased from 16.1 per cent to 25.8 per cent.
Many who die at home use the society’s night nursing service, which sees a registered nurse care for the patient from 11pm-7am. The service, which is free for 10 nights, is entirely funded by public donations, mostly made during the charity’s Daffodil Day fundraising drive.
Due to Covid-19 restrictions, the society cannot carry out its usual on-street collections and other fundraising events on Daffodil Day, which is today, for the second year running. Daffodil Day earnings fell by €2.3 million last year.
With pandemic restrictions hampering fundraising efforts again this year, the society is seeking to raise awareness of the service and to find more nurses willing to help it meet the increased demand.
Anna Drynan Gale, a southeast region night nurse based in Co Kilkenny, says she has noticed an increase in demand in the past year.
Level of care needed
She says a majority of terminally-ill people want to die at home rather than in hospital or a nursing home, but families fear they cannot deliver the level of care needed.
“Most people think they don’t have any medical, nursing or caring skills...but all these skills come to the fore, with guidance and support,” she says.
Ms Drynan Gale says the night nurses do their best not to intrude on families dealing with a loved one’s illness at home.
“People can die surrounded by their loved ones, it is really special,” she says. “Saying goodbye is very important, people often leave things unsaid until those final days. You can’t do these things over Skype if someone is that clinically unwell or dying... you really need that face-to-face interaction.”
Ms Drynan Gale also encouraged other nurses to join the service, which “makes such an important difference” to an ill person and their family.
Annemarie Ward, a night nurse for the south Dublin region, says their presence in a home overnight allows family members to get a full night’s sleep knowing their loved one is being cared for.
“When someone is dying, families can be under serious pressure. This is compounded by not getting enough sleep, it’s not easy,” she says.
The nurses also administer pain relieving medication and monitor the patient’s symptoms. She says the home setting allows people to die peacefully.
“I’ve said to people they can sit on the bed beside the patient, it’s their husband or grandfather. They can do what they want as they are in their own home.”
Ms Ward says some night nurses read a quote by Dame Cicely Saunders, the founder of the modern hospice movement, to patients in their last moments as a comfort.
It states: “You matter because you are you, and you matter to the end of your life. We will do all we can not only to help you die peacefully, but also to live until you die.”
Antoinette Britton’s husband, Brian, died at home in Blackrock, Co Louth, after being diagnosed with leukaemia in November 2017.
“His chemo stopped working. One of the first things he said to me was that he wanted to die at home,” says Ms Britton.
By the end of January 2018, the blood and platelet transfusions that her husband had been getting stopped working. He met the palliative care team in St James’s Hospital and they agreed he could go home to die in peace.
She says there was a “tsunami of help” available to the family at that point.
“We had a nurse every night. Before the night nurse came, I hadn’t been sleeping at all,” she says. “I was petrified that something would happen to him, I was absolutely exhausted. For the first time in months, I could actually sleep.”
The night nurses were supportive of the entire family, and they had a calming presence. “It’s hard to talk about dying at home, people don’t know who to turn to. Just ask, the service is there.”
She hopes the pandemic does not have a negative impact on the society’s ability to provide this “vital” service.
“Brian would not have been able to die at home without it,” she says.
Michaela Kelly’s grandmother, Bernie Campbell, died last summer after being diagnosed with bone marrow cancer the previous December.
Ms Campbell, from Blackrock in Dublin, and her family were told in July that blood transfusions had stopped working.
“Bernie rang my mum crying, saying she wanted to come home to die,” says Ms Kelly. “Bernie had already spent a great deal of time in hospital, and the restrictions were so strict we were worried she’d die alone.”
Ms Kelly says her grandmother spent two weeks at home before she died and having a night nurse was invaluable.
“She was like Mary Poppins, she arrived every evening, fully clad in PPE,” she says of the nurse. “She was so diligent. She sat beside Bernie, awake all night, noting down everything.”
One morning, the nurse told Ms Kelly’s mother that she believed Ms Campbell would die soon, and they should say goodbye.
“It was like she had an innate sense, Bernie passed away a few minutes afterwards. We want to express our gratitude to her.”
Friday is Daffodil Day and donations can be made to the Irish Cancer Society at cancer.ie/daffodilday