The Case for Hospice Care in Co Wicklow
Back in 1999, a Department of Health needs assessment highlighted the lack of hospice beds in Wicklow. In 2009, the Health Service Executive’s Five Year Palliative Care Plan provided for a 12-bed Wicklow hospice by 2012. The regional HSE palliative care committee approved the plans and location. St. John of Gods, a reputable provider of clinical care, is ready to operate the hospice, subject to agreed ongoing funding. But due to the current economic climate progress has stalled.
The Department of Health’s 2001 national palliative care policy envisaged integrated palliative community care services. National policy is that 1% of all hospital beds should be hospice beds and that there would be 1 hospice bed per 10,000 of population. However, Dublin’s Blackrock 12-place Hospice is the only hospice for people in the Dublin East Coast Area and East County Wicklow. This is only one third of the agreed bed numbers for the area’s 350,000 population. The new 15 bed Wicklow Hospice will reduce Dublin/East Coast Area’s hospice bed deficit and care for the hundreds of Wicklow people dying in Dublin’s acute hospitals every year.
National Access to Specialist Hospice Care
Hospice care access is greatly influenced by regional expenditure. The HSE spend €35 per capita on specialist hospice care in the Mid West and North West, compared to €17 in the Dublin East Coast Area and €3 per capita in Wicklow. Wicklow hospice homecare patients are four times more likely to die in an acute hospital than Mid-West homecare patients.
Community hospice care, supported by a hospice inpatient unit, provides the best quality and most cost effective end of life care. Where comprehensive hospice services are provided, 90% of patients are in homecare and just 10% in hospice beds. The hospice inpatient unit is the service’s “hub” which also supports patients in day-care, at home and in long stay nursing home beds. Most people prefer to die at home, surrounded by loved ones. Only 25% of all Irish deaths are at home. In contrast, 42% of patients with hospice homecare die at home. The cost of hospice homecare, per patient, over the last six months of life is less than €1,000 – the equivalent cost of one day in hospital. The absence of a hospice in Wicklow forces many patients who are actively dying and in need of complex care to travel to Dublin’s busy acute hospitals.
The hospice service ethos is to deliver the highest possible standard of care, allowing people to maintain their dignity and quality of life. Palliative care encompasses the patient’s mental, spiritual, physical and emotional needs.
Coming to the end of life is a very special and privileged time. In Wicklow, community support for a hospice is so overwhelming that so many volunteers, local organizations, clubs and businesses have come together to fully fund the building of a hospice so that families, carers, friends and neighbours can rest assured that their loved ones will receive the end of life care that they rightly deserve. The HSE’s and the Department of Health have now agreed to provide annual operating funding of €3m in 2018. Harold’s Cross Hospice have agreed to become the hospice operator.