THERE IS a serious mismatch between where people want to die and where they actually die, according to a leading expert in end-of-life care.
Tessa Ing, head of End of Life Care Strategy at the English Department of Health, was speaking at a workshop on the subject in Dublin yesterday, part of an ongoing forum on end-of-life care organised by the Irish Hospice Foundation.
In England about 75 per cent of people, when asked, say they wish to die at home, but only 19 per cent do so, Ms Ing said. Over 65 per cent die in acute hospitals, and about 5 per cent in hospices. Over 54 per cent of complaints in acute hospitals relate to care of the dying or bereaved, she said.
The End of Life Care Strategy in the UK aims to ensure access to high-quality care for all people near the end of life, and increased choice for all adult patients in England on where they live and die, regardless of their condition.
A BBC survey in 2005 revealed that only one third of people had discussed dying with anyone.
“As a society, we in England do not talk about death and dying,” Ms Ing said. “This makes care planning difficult for health services. To make change happen, you must raise the profile of death and dying.”
Rev Dr Michael Wright of the International Observatory on End of Life Care at Lancaster University told the workshop that palliative care is not available in many countries.
Ireland was one of only 15 per cent of countries worldwide where palliative care was integrated into the national health service, he said. He acknowledged the key role Irish Aid has played in supporting the development of hospice/palliative care in poorer countries, particularly in Africa.
Morphine consumption had increased 10-fold in the past 20 years, he added. However, the seven high income countries accounted for about 84 per cent of global morphine consumption, but for less than 12 per cent of the world’s population. Inadequate supplies of morphine was a major barrier to palliative care, he said.
The forum has received over 140 submissions from individuals and groups. Meetings will take place in Waterford on October 27th and Tullamore on October 28th, with a national coalition on the issue to be set up next year.