Palliative care for all, not just cancer patients, hospice urges

by Grainne Cunningham

NO-ONE should have to endure the “fear and the pain and the dread” that goes with terminal illness without the sort of palliative care received by writer Nuala O’Faolain in her dying days, her old friend Marian Finucane said last night.

Ms Finucane, director of the Irish Hospice Foundation (IHF), said it is “bewildering” that we have progressed so far in one direction with the provision of palliative care for cancer patients while others are refused on the basis of diagnosis.

The palliative care offered to Nuala O’Faolain was “absolutely essential not just for her physical comfort but for her peace of mind”, she said. Ms Finucane was speaking at the launch of a report entitled ‘Palliative Care for All’, a joint research project by the IHF and the HSE looking at how best to extend palliative care for patients with conditions other than cancer.

Some 95pc of the 6,000 people who access hospice/palliative care services in Ireland are cancer patients, and care has traditionally been provided by the voluntary sector.

However, the State is now the major funder of palliative care and “it would not be appropriate that State services were only available on the basis of diagnosis”, said IHF chief executive Eugene Murray.

“It should be on the basis of need,” he said, adding that a general level of palliative care should be available to all people suffering from incurable advanced disease.

Co-launching the report, Laverne McGuinness, of the HSE, spoke of the need to treat the terminally-ill as close to home as possible. This year, 2,000 to 3,000 dying people were cared for in their own homes, together with 370 who received inpatient care.

The HSE has a budget of EUR76m for the provision of palliative care during 2008, she said.

The report focuses on three life-limiting conditions – chronic obstructive lung disease, heart failure and dementia.

It has recommended that three part-time clinical facilitators be recruited, for two years from 2009, to work with medical professionals to ensure palliative care is included in disease service plans. Other recommendations include:

• The introduction of monitoring systems to ensure specialist palliative care (SPC) is provided on the basis of need rather than diagnosis.


• The introduction of an endof-life strategy for all health staff working with the terminally ill to help them maximise quality of life and to die with dignity and comfort.


• Education and training for all SPC staff to gain greater depth of understanding of palliative care.


• Patients who are thought to be dying imminently and have chosen to do so at home should be able to avail of SPC if required.

A forum is to be established to implement these recommendations.