AS MANY carers will attest, it can be tough minding those who are in their final years. Most pertinent of all, hospital patients at that juncture can sometimes be left alone, frightened, and even in pain.
With the natural emphasis on curing, doctors, nurses, allied health professionals and even relatives can forget that comprehensive care is needed for those in their final days. How we deal with this phase of life is often described as a measure of our humanity.
Recent events bring such issues into sharp focus. First, there was the visit earlier this month by Fine Gael leader Enda Kenny to Leopardstown Park Hospital in Dublin where, he told the Dáil, he found elderly people living in undignified and cramped conditions. Second, writer Nuala O'Faolain prompted a national conversation with her harrowing disclosure of her despair at being diagnosed with terminal illness. And, finally, a report commissioned by the Hospice friendly Hospitals Programme and the National Council on Ageing and Older People charted enormous gaps in services, despite many Government promises.
Out of 20,080 hospital beds, there are only 108 designated for palliative care. There is a also a significant gap in palliative care education and low access to consultant-led palliative care teams. The scarcity of bereavement officers and support for relatives who have lost loved ones will not surprise. Nor will the suggestion that the neglect of end-of-life care may reflect ageist attitudes, such as in doctors who hesitate to treat pain in older people.
Other crass perceptions - for example that an older person's death is less important than that of a younger person - can affect the allocation of resources for the elderly and those in end-of-life care. They also add a cruel touch to an environment where it is still accepted that people will die in cramped long-stay wards, surrounded by noise, human sounds and smells. At its worst, this is mere warehousing of the most vulnerable.
The report, however, will encourage the Hospice friendly Hospitals Programme in pursuing its demand that the 30,000 people who die in Ireland each year are entitled to what is termed a good death. Organisations for the elderly will also welcome a report which is about much more than palliative care. Its section on Advanced Health Care Directives deserves avid public debate, touching as it does on issues of personal autonomy and the moral right of people to make intimate decisions about themselves, subject to law.