There is broad support for the view that in Ireland we do dying, death and bereavement well but that further investment in services provided is needed, writes Denis Doherty. The work of the Irish Hospice Foundation (IHF) over the past 39 years has contributed greatly to the improvements that have been achieved over that period. The recently launched IHF strategy 2025-2030 promotes a vision of an Ireland where ‘people facing death, or dying are provided with the information, care and support that they need.’ A not unreasonable ask, surely?
It remains true that the only certainties in life are death and taxes. As a society we can, if we wish, demand that more of the taxes we pay are used to give effect to the wishes of those who supported the view, set out in the IHF charter on Dying, Death and Bereavement “to live and die in an Ireland where I can prepare for what lies ahead”
The ancient Irish toast that ended with the words “agus bás in Éireann” is not often heard nowadays but remains the desire of many older Irish emigrants. In Ireland, we have always done death and dying our way and arguably better than how it has been done in many other societies. Those whose wishes are granted and experience the best care now provided here for the dying will have made a good decision. Standards generally are high and there is recognition that for those who fear dying more than death, homecare and palliative care delivered on planned, outpatient or short stay residential care is being expanded. Local hospice groups continue to provide valuable services to patients and families. In recent years the network of hospices, capable of delivering palliative care of the highest standard, have been built and commissioned. The recent government decision to fund the capital and revenue costs of new hospices provides the prospect that soon patients throughout Ireland will be able to avail of the hospice services, best suited to their medical needs, near to where they live.
The IHF strategy does not dwell on the enduring problem of lack of capacity in A&E and medical departments of our acute hospitals. In normal circumstances our hospitals cope well when caring for patients who are dying and their relatives. The appreciation they attract in death notices is testament to that. When need exceeds capacity, hospitals cannot be expected to provide the level of privacy patients and their relatives deserve. Negative experience of that sort compounds the grief relatives experience.
The term ‘good death’ sounds like an oxymoron but the IHF strategy is enlightening in that regard. Dame Cicily Saunders, is credited with having performed a leading role in promoting the need for hospice care. She promoted the view that end of life experiences must address what she called ‘total pain’, encompassing a person’s physical, psychological, social, spiritual and practical struggles.
The IHF Strategy 2025-2030, titled “Every Death Matters: Transforming Dying, Death and Bereavement” is ambitious and persuasive in stating its supporting argument in plain English, over only 27 A4 pages. It merits study and consideration by policy makers, funders and all health and care services managers as well as all those involved in providing end of life care services.
The Minister for Health launched the strategy document on the 8th May at a well-attended and informative event. The Minister had clearly studied the document in advance of the launch and came across as very supportive of it.
The IHF 2025-2030 Strategy can be viewed at hospicefoundation.ie
