End-of-life care study reveals variations in pain management

MARKED variations in pain management for older people dying in hospitals and nursing homes have been found in a significant study of end-of-life care.

It also found there were very few dedicated palliative-care beds available for terminally ill patients.

There was not enough formal bereavement support before and after death and a lack of privacy and accommodation for family and friends who want to stay with their loved ones when death is imminent.

Of particular concern was the variations in pain management between facilities, which was often dictated by access to specialist support services.

The study of more than 300 acute care and other long-stay facilities found there were just 108 designated palliative care beds out of more than 20,000 beds in the health system.

The study, End-of-Life Care for Older People in Acute and Long-Stay Care Settings in Ireland, was commissioned by the National Council on Ageing and Older People (NCAOP), and also the Irish Hospice Foundation.

More than 7,000 people who die in Ireland each year are over 65 years of age.

Chair of the NCAOP Dr Ciaran Donegan said the neglect of end-of-life care is indicative of society’s ageist attitudes towards the elderly.

“Clearly, the eradication of ageist attitudes and behaviours that tolerate the neglect of end-of-life care for older people must be a primary concern for leaders in society and those charged with promoting equality of treatment for all,” he stressed.

The report found significant gaps in education and training on palliative care.

Less than 33% of facilities confirmed their qualified nurses held any form of post-registration qualification in palliative care.

And just more than one-in-10 respondents said doctors in their facility had received any form of specialised training in the area.

Chairman of the Irish Hospice Society, Denis Doherty, said the focus must be on identifying and embracing a compassionate approach to care that supports older people in life and death. “People should always take precedence over paperwork,” he said.

The HSE pointed out that €14 million had been spent on enhancing palliative care services over the last two years and it was committed to spending a further €3m for additional developments this year.