Countywide, about 40% of palliative care patients die in acute hospitals. But the figure for the greater Limerick area is less than 12%.
The dramatic change in the lives of people coping with terminal illness is due to the manner in which Milford Care Centre Hospice in Limerick has developed its extensive community and home-based services.
Last year, Milford Care Centre looked after more than 1,800 patients, in both the centre and in their own homes — compared to 868 just 10 years ago.
The vast majority of its patients avail of community and home visit services.
The care centre is now embarking on an €8.5m development plan to increase its in-patient accommodation to 34 private rooms in the 47-bed facility.
The JP McManus foundation and community fund is donating €3.4m.
Over the past 10 years, patient profile at Milford has seen a major change.
In 2004, about 90% of patients had cancer. Today, cancer sufferers account for 62% with the remaining 38% being treated for motor neurone disease, multiple sclerosis, dementia, renal failure and other illnesses.
While huge resources and most of the 350 Milford staff are deployed at the care centre in Castletroy, great importance and planning is also being put into expanding Milford’s presence in the Mid-West generally where it has small satellite accommodation units in Clare, north Tipperary and Co Limerick.
Milford has now embarked on a pilot scheme called The Compassionate Communities Project, in which 15 volunteers are undergoing special training to act as ‘good neighbours’ to palliative patients who are being treated at home.
The aim is for the ‘good neighbour’ to fulfil simple but important roles, such as helping with school runs, shopping, calling for a chat or taking a dog for a walk.
The project initially is being focused on a 20-mile radius of Limerick City.
Pat Quinlan, Milford Care Centre chief executive, said: “The compassionate community project is going back to the old concept that ‘there is one of our neighbours very ill and we need to try and find out if the local commuity can support that neigbour in any way’.
“We are now training up good neighbour leaders in communities and they will go in and offer support and harness the goodwill that is there in a way which is not intrusive. It is going back to the way things were many years ago. There is a huge untapped resource of goodwill out there.”
He said palliative care focuses on providing the highest quality of care and support in situations where curative interventions are no longer an option.
He said: “The majority of patients in an ideal scenario, want to die at home. Over the past number of years we have been putting together integrated services. With the HSE and ourselves, we have developed services in the community. We have a support-bed network throughout the region in Clare, North Tipperary and we are developing one in Newcastle West to and try keep a patient in their own community or at home. They only come to Milford if there is a complex medical condition and need the specialist team of consultants here to assess the patient, and get the patient back home again.”
Mr Quinlan said: “We have a fully developed integrated model of the in-patient hub in Milford with three consultants . We have a very integrated service between oncology services and palliative care.
“Our model of care in the Mid-West has probably come closest to the model set out in national policy, the 2001 report on palliative care. We have come closest to delivering on that particular model.
“That model would be the specialist palliative care unit as the hub — Milford — and a support bed-network in the community which works closely with the primary care teams.”
He said this strategy of keeping palliative patients away from acute hospitals takes pressure off an already overcrowded environment, which lacks the privacy needed for important contact with family members.