Marymount Hospice: Educating for a healthy approach to palliative care

Marymount Hospice runs a programme on the fundamental aspects of loss, grief, and bereavement that is open to everybody, including the public, writes Colette Sheridan

Director of education at Marymount Hospice in Cork, Geraldine Lynch, says that while her job can be very sad, it is also “very rewarding and necessary work”. Geraldine, who has been working with the hospice for 15 years, having secured a degree in nursing at UCD and a master’s degree in education at UCC, as well as working in the School of Nursing at Cork University Hospital, stresses the importance of continuing education in palliative care.

“We provide in-service education and continuing professional development (CPD) education for our own staff, as well as for healthcare providers across the HSE South. In addition, we provide academic education with a post-graduate diploma in palliative care with UCC and a CPD module on palliative care. We’re hoping to develop the post-grad to a master’s degree. The education centre aims to facilitate the professional and personal development of health carers, giving them the necessary knowledge, attitudes and skills and to have this reflected in the care and services provided to patients and families.”

As part of Marymount Education Centre’s commitment to CPD, a holistic approach to palliative care is offered to groups of 30 professionals.

It also runs a five-day programme on the fundamental aspects of loss, grief, and bereavement.

“That programme is open to everybody, including the public. When people come onto this programme, you may not know their professional background and personal experiences. A proportion of the programme deals with participants’ personal experience of loss and their professional experiences. You may get someone on the programme who’s upset. I’m very conscious of looking after the participants. We provide some psychological support during the programme.”

With access to clinical experts, the education centre at Marymount provides insight into theories.

“It’s a good combination and is one of our huge advantages. We only started the fundamental aspects of loss, grief, and bereavement programme last year. We’ve had funeral directors on the programme, chaplains, a lot of nurses, healthcare assistants, psychologists, and interested members of the public,” says Geraldine, who explains that there has been “an explosion” in the literature around grief. The thinking about it is no longer confined to Kubler Ross’s five stages of grief.

“When you’re bereaved, the biography of the deceased is important. At a funeral, people are trying to put the person into a context. You might know the deceased as your dad, but somebody else can remember them as a child they went to school with. No one model fits every person or every family. In the programme, we look at the impact of culture. Because Ireland has become multi-cultural, it’s important to be aware of how different cultures respond to grief and bereavement.”

There are misconceptions around palliative care.

“A lot of people think it’s terminal care, but palliative care can be given much earlier in somebody’s diagnosis. With palliative care, we often refer to end-of-life care as the last days or hours of life.

“ Palliative care includes dealing with people’s symptoms. Somebody might be in pain and have nausea and vomiting. They could be fatigued and feel absolutely wretched. The word ‘palliative’ means to cloak or mask symptoms, so, palliative care can get the pain and vomiting under control so that the person begins to feel better. Palliative care is about improving people’s quality of life. That has a knock-on effect on their family’s quality of life. A multi- disciplinary team is needed and we’re lucky in that we have nurses, doctors, social workers, chaplains, physiotherapists, healthcare assistants, and others.”

Palliative care can be provided anywhere, including at home.

“We have a community palliative care team. They cover the North Lee, South Lee, and north Cork from Marymount. We have a satellite team based in Bantry and they look after West Cork, as well. They go out to people’s homes, working with the GP and the public-health nurse. This helps keep people at home for longer. This is something that is going to become increasingly important as people live longer lives.

“More people will develop dementia, which is becoming more prevalent in palliative care. Palliative care is also provided in nursing homes, community hospitals and acute hospitals, as well as in hospices.”

Marymount also has outreach programmes linked to Munster hospitals, nursing homes, and schools.

“When talking at schools about hospice, inevitably, it turns into talking about cancer. You’re dealing with children, so you have to be careful, because you don’t know what their experiences have been. Some transition year students come into Marymount Education Centre to have talks on palliative care.”

There is “huge fear around hospice, but people do go into the hospice and then go home. We have fabulous facilities. People have their own en-suite bedroom and families can stay if they need to. I have never worked anywhere that has so much involvement with families. At Marymount, when a patient comes in, the family comes in as well.”