Derry consultant highlights the need for improved palliative care services in north
Jenny Lee chats to Derry consultant in palliative medicine Dr Damien McMullan about how palliative care can benefit those living with a life-limiting illness or condition
WHEN most people hear the term ‘palliative care’ they immediately think 'end of life'. However, this isn’t entirely accurate. Palliative care is actually not about dying; rather it is about living as well as possible with a serious illness.
Palliative care is often introduced as people near the end of their life as it is vital they are comfortable and receive dignified care at this time, it can also be provided at any time for a person with a life-limiting illness to help them and their family live within the limitiations of their illness.
Challenging misconceptions of palliative care and raising awareness of the difference it can make to patients, carers and families throughout Ireland is the aim of Palliative Care Week 2019, which continues until September 14.
The theme for this year is Palliative Care: Surrounding You With Support, with a focus on how people with palliative care needs are being supported in the community. This could involve support from primary care (such as GPs, public health nurses, district nurses), from hospice, hospital, nursing home, and wider community support beyond formal health and social care services.
Dr Damien McMullan has worked for the past seven years as a consultant in palliative medicine in both Foyle Hospice and Altnagelvin Area Hospital. He is keen to stress that palliative care is for all ages and conditions.
"Palliative care focuses on helping a person of any age, with any life-limiting condition to live well for as long as possible. It seeks to help them achieve the best quality of life as their illness progresses. It involves the management of pain of their symptoms and provides social, emotional and spiritual support.
"Palliative care can benefit people who are living with a life-limiting illness for years as well as those who might be the last months, weeks or days of life. These include conditions such as heart failure, advanced lung diseases, kidney failure, motor neurone disease and dementia, as well as those living with advanced cancer."
Acknowledging that there is still a social stigma around death and dying, Dr McMullan encourages families to talk about their individual wishes for palliative care.
"Having these conversations is more than hard, especially when you are in the midst of being given a diagnosis or being told things are getting worse. Everybody is different, and of course we respect those who don't want to talk about the future, but we generally find that openness means we can provide better person-centered and family-centered care."
While spending their last days at home is a desire for some, medical needs as well as available resources sometime mean this isn't always possible, as Dr McMullan explains.
"It's hard to underestimate how difficult it is for families coping with a loved one dying at home and sometimes even with all the support available it can become too much.
"Supporting patients' wishes is core, but it's as important to focus on how someone is cared for and how they die as much as where they die. It's crucial that people are able to die with dignity wherever they are – whether that be home, hospice, hospital or nursing home – and for that to happen you need to have the appropriate staff."
With an ageing population and people surviving with life-limiting complex conditions, the need for palliative care will be even greater.
"The huge pressure on the healthcare service is undoubted. The lack of a functioning executive and Brexit make it very difficult to help develop palliative services, especially with regard pilot projects.
"In Foyle Hospice 30 per cent of the total annual running costs come from the NHS through the Health and Social Care Board and the rest, the 70 per cent, is dependent on fundraising and incredible public generosity. Despite this, Foyle Hospice, like many hospices, has been running a growing deficit over the last two years which could impact on its ability to provide the care patients and families need," says Dr Mullan, who recognises the huge role the general public play through donations and volunteer work.
Ensuring carers and loved ones are supported is another crucial part of palliative care and within the North West area, there are a number of available services including: Compassionate Communities befriending partnership; Healing Hearts children's and young person’s bereavement support, run through Foyle Trust; and day respite through Foyle Hospice, which has over 500 volunteers who support staff by offering services and support from complementary therapies and entertainment to hair treatments and gardening.
:: Palliative Care Week is facilitated by the All Ireland Institute of Hospice and Palliative Care (AIIHPC). For extensive resources on palliative care visit Thepalliativehub.com