Ombudsman calls for improved care for dying patients

A 79-year-old woman who telephoned her son from her hospital bed to say she was dying was one of the worst complaints about end-of-life care received by ombudsman Peter Tyndall.

Ombudsman calls for improved care for dying patients

The woman, a patient in an acute hospital, died later the same day. Her son went to the hospital as soon as she called him, but was not told for a further four hours after his arrival of the seriousness of his mother’s condition.

As a result of the hospital’s failure to speak to him, other members of his family did not have time to travel home to be with their mother when she died.

The hospital admitted there had been a failure to contact the next of kin in a situation where there was clear consent and clear evidence of a deteriorating condition.

The complaint is one of many detailed in the ombudsman’s report A Good Death, which highlights how end-of-life care in Ireland can be improved.

Launched yesterday, it stresses the importance of hospitals having good communication, support for patients and families, and appropriate procedures, both before and after death.

“I hope these real-life experiences will make a positive contribution to the national debate on end-of-life care and the campaign to make Ireland a good place to live and die in,” said Mr Tyndall.

Last year, about 130 of the 3,200-plus complaints were about acute hospitals and long-stay, care settings.

The ombudsman has already expressed concern that relatively few people complain when they are unhappy with the service they receive. However, Mr Tyndall stressed that the purpose of the report is not to point the finger or to lay blame.

“This is purely a reflective and learning exercise. For that reason, the anonymity of settings and of individuals has been preserved,” he said.

Mr Tyndall said all of the people in the stories related in the report have had highly regrettable experiences in hospital at the time of a final illness and death of a loved one.

“Their experiences are being retold to show how things can go wrong and to show how we can learn from past mistakes,” he said.

In particular, he said there was a lack of understanding about ‘do not resuscitate’ decisions. “Patients and their families, or next of kin, need to understand what such a decision entails and who holds responsibility,” said Mr Tyndall.

The Ombudsman’s Office has received many complaints over the years relating to autopsies.

In one case, a hospital did not perform an autopsy following a patient’s fall. As a result, the family of the dead man did not know whether he had died of the admitting cause, a stroke or as a result a head injury.

After the ombudsman intervened, the hospital apologised unreservedly to the family for the distress caused and undertook a range of initiatives.

The report was launched at the Chester Beatty Library in Dublin Castle, where there was also a preview screening of the RTÉ documentary, Way to Go? Death and the Irish, which will air next Tuesday.

The documentary features first-hand experiences of people who are dying, as well as health professionals.

There are also thoughts and anecdotes expressed by actor and Irish Hospice Foundation patron Gabriel Byrne and broadcasters Marian Finucane and George Hook.

Failures in end-of-life care

• The family of a woman who died after being treated in hospital for lung cancer said they were not told about her prognosis until she was unconscious;

• A daughter was not told of her father’s deteriorating condition, at his request, but staff failed to alert her before she reached his bedside;

• An 87-year-old woman in an acute hospital was told by her doctor she was terminally ill without first being asked if she wanted to have a family or staff member with her;

• A son complained that his mother, who was being treated for cancer in hospital, was in agony for five days before her death, because the hospital had not contacted the on-call palliative care team;

• A daughter complained that a hospital failed to arrange for pain relief for her mother when she was discharged from hospital and the public health nurse did not visit her until the day before she died;

• A woman complained that her late partner’s belongings, both soiled and clean, were returned to her by the hospital in green plastic bags.

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