Government urged to develop national strategy on end-of-life issues

The Government has been urged to develop a national strategy on palliative care, end-of-life issues and bereavement to include both health and non-health areas of public policy.

Publishing its pre-budget submission on Thursday, the Irish Hospice Foundation (IHF) also called for the restoration of the bereavement grant and the commencement of the Assisted Decision Making (Capacity) Act 2015 in full as a matter of urgency.

The restoration of grant would cost an estimated €25.5 million a year based on 30,000 eligible people.

The foundation also called for the funding of 10 additional end-of-life care co-ordinators across the six hospital groups at an estimated cost of €600,000 per year. Nine end-of-life care co-ordinators to improve supports in residential settings would cost a further €540,000.

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In the next 10 years, almost 300,000 people will die in Ireland, with more than 240,000 of those people aged over 65. Almost three million people will be bereaved and up to 150,000 of these will encounter ‘complicated grief’.

If those trends continued, five to 10 per cent of grieving people, or 15,000 a year, would require specialist mental health services or psychological intervention.

“By careful planning, we can make the best use of the substantial funds that we directly and indirectly invest in the care of the dying and the bereaved and, crucially, this planning includes helping people to live well until they die,” the IHF said.

The organisation urged the Government and all Oireachtas members to ensure bereavement issues were a priority for policy development and investment.

It said death was “an inevitable and universal experience – a fact of life”.

"Death is not just about old people," said Angela Edghill, advocacy and public engagement manager.

She said a “whole of society” approach to end-of-life issues was required.

Orla Keegan, head of education, research and bereavement, said bereavement affected people emotionally, but also affected their day-to-day life and their social function.

“Throughout the architecture of the State, bereavement is not catered for,” Ms Keegan said.

About 15,000 people a year were “paralysed in grief” and the mental health services were not picking up on that. There was also a cluster of economic issues that had not been examined.

The IHF said the recent Sláintecare report was an important development outlining a 10-year plan for radical reform of the health system. But despite its comprehensive look at the health services, “sadly bereavement was forgotten in the report”.

A substantial study published recently by independent Senator Marie-Louise O’Donnell examined the role of the State in dying, death and bereavement.

Noting there were supports in place in some areas but not in others, the Finite Lives report said there was little account taken of the signals the State sent out to people who were approaching the end of life, or to those whose lives would be changed forever by the loss of a loved one.

One “glaring example” of this had been the discontinuing of the bereavement grant.

The Senator said the “lack of social and emotional intelligence” on the part of the State could “more damage than can be undone by a new and (arguably) more user-friendly payment support system.”