Tá an-áthas orm bheith anseo libh inniu agus muid ag céiliúradh an ócáid mhór seo. Ba mhaith liom mo bhuíochas a chur in iúl daoibh as an gcuireadh agus as fáilte a bhí caoin, cneasta agus croíúil.
My thanks to Mr. Mervyn Taylor for his kind invitation to launch this important and reassuring initiative and to each of you for your warm welcome.
Hospice Care goes right to the very heart of an exceptionally difficult area of human life – how to cope effectively with a life-limiting illness and the process of dying itself. Given the inevitability of death and its frequency you would think that all these centuries of experience would have bequeathed us a distilled wisdom, easily accessed and applied, as soon as there is a diagnosis of a terminal illness. The truth is, though, that while we have age old established rituals to cover wakes and funerals which help us to cope with the early days of bereavement, it is only in very recent years that we have applied our ingenuity to better management of the dying process – the very part that tests us most, and frightens us most whether as patients or as family. We many be resigned, or angry, or disbelieving when confronted with the reality of death drawing near but the big challenge is to make the days left in our lives, as full, as independent and as pain free as possible. This is where the modern discipline of palliative care, exemplified by the Irish hospice care movement, is bringing a whole new perspective and partnership into focus and into service.
In 2004, the Irish Hospice Foundation, with the support of the National Partnership Forum, undertook the first, ever, nationwide public opinion survey on attitudes and experiences regarding death and dying. The findings highlighted things we all probably knew from intuition or from experience – that what matters most to people at the end of life is to be surrounded by those they love, to be free from pain, to be conscious and able to communicate and most significantly the vast majority would prefer to die at home. In reality of course over half die in hospital and only a relatively modest number will have access to hospice care. These are important voices and important findings for they inform medical and nursing care and practice, in a scholarly way, from the patient's perspective. They have an authenticity and a rightness about them which is insistent and which completely vindicates the value system which underpins the concept of hospice care. They beg the questions as to whether and how the ethos of hospice care can be mainstreamed into general hospitals and the Hospice Friendly Hospitals Programme answers those questions. The initiative builds on the work of the award winning pilot project undertaken in Our Lady of Lourdes in Drogheda and its national roll-out is made possible thanks to a very strong partnership between, the Irish Hospice Foundation, the Health Service Executive and Atlantic Philanthropies.
Hopefully the Hospice Friendly Hospitals programme will provide a route map for the development of considerably more nuanced and customised care designed specifically for people dying in hospitals and their families. Spiritual and existential issues arise in complex ways – sometimes as much for family members and the hospital staff as for the person actually facing death. More mundane but highly important issues of space and privacy also arise and are directly connected to issues to do with the coherence of the hospital experience and the culture of sensitivity it produces.
This initiative enables the valuable lessons and experience of the hospice environment to be shared with colleagues caring for the dying in an acute setting and it helps promote the philosophy of palliative care right through the whole edifice of health and social care.
We are still only at the start of learning what palliative care is capable of. New drugs, new technologies, new skills are helping take the dread of suffering out of the dying process, something that matters hugely to each one of us. We know that none of us will defeat death itself but if we could be sure of defeating the physical suffering and minimising the emotional suffering, that would bring great reassurance and comfort.
Just recently an elderly relative of mine died in hospital. His death was well heralded and the care he received was superb. It was a care that extended to his large family, one of whom remarked that having watched him die such a careful death she would never again be afraid. That is what we want for all those facing death, a careful death, careful of small things and big things, careful of the physical, the emotional and the spiritual needs, loving care that helps make the process of dying as life-enhancing as it can be.
I thank everyone who has helped in developing this pioneering project. It is likely to take care for the dying into a new era and will hopefully fulfil the vision of the Irish Hospice Foundation IHF vision to provide those facing the process of death and bereavement with the very best of care and the very best of support.