Hospice survey highlights key concerns about care for dying

National study: Two-thirds of Irish people would like to be cared for at home if they were dying yet every second person dies in hospital, according to the first national survey on attitudes to death and dying.

The survey, which was commissioned by the Irish Hospice Foundation (IHF) and published yesterday, also found 80 per cent of Irish people believe hospital care for people who are dying or are terminally ill needs improvement with 40 per cent believing such improvement is needed urgently.

The majority of respondents described the provision of care for the terminally ill as "very or extremely" important.

"We hope this survey will begin a national debate on death and dying, what people want when they are dying and why so many people die in hospitals when they want to be at home," said IHF chief executive Eugene Murray.

According to the survey, the three most important things for Irish people when they are dying are: to be surrounded by people they love, to be free from pain and to be conscious and able to communicate.

Only 10 per cent expressed a preference for dying in a hospital. Commenting on the fact that so many people die in hospital while the majority would prefer to die at home, Orla Keegan, education, research and development manager at the IHF, said: "This is due to inadequate nursing and primary care team support in the community as well as the reality that interventions are sometimes needed and that people [ and their families] can change their minds about this preference to be at home when faced with a serious illness."

The perception that people don't like discussing death is inaccurate as the survey found 51 per cent of Irish people felt there is not enough discussion about death and 79 per cent stated they were comfortable discussing death or dying generally or talking to those who have been recently bereaved.

When it comes to discussing their own death or putting arrangements in place if they became terminally ill, the reality is different.

For instance, 86 per cent of Irish people have not told anyone where they would like to be treated if dying, 79 per cent have not told anyone what they would like at their funeral and over half of Irish people have not drawn up a will. Fourteen per cent of Irish people have written up an advance directive or "living will".

The national survey on attitudes to death and dying is part of research for the two-year project Care for People Dying in Hospitals, which is an IHF initiative involving the North Eastern Health Board at Our Lady of Lourdes Hospital in Drogheda, Co Louth. The aim is to bring more attention to issues around privacy, facilities for families, communication with medical personnel and an integrated approach to care.