ON THE world's stage, as Shakespeare said, men and women are merely players who have their exits and their entrances. Of course some never reach the seventh age of the cycle of life cited by the Bard. Their lives may be cut short by terminal illness, very often cancer. Such illness presents a challenge not just to the patient but to his or her family and to the health service.
In Ireland for more than two decades, the voluntary hospice movement has been coping valiantly with end-of-life care by providing palliative support for the terminally ill. That support helps to alleviate the pain of the dying patient and tries to ensure that death comes with dignity and in some comfort - whether at home, in hospices or in specialist hospital units. Palliative care includes support for a family in their bereavement.
In the national debate about the provision of healthcare, no part of the much criticised health service gets less attention than the hospice movement. The Irish Hospice Foundation (IHP) was set up in 1986 as a voluntary support organisation for the development of hospice services. Its primary concern then was to provide palliative care for cancer patients. Certainly, it has succeeded. At present, some 95 per cent of the 6,000 people who access hospital/palliative care services each year are cancer patients. Since 2001, the State has become more involved in developing end-of-life care services and in extending access to them. Overall, however, national palliative care remains inadequate and unbalanced.
More people die from life-limiting medical conditions - chronic obstructive pulmonary disease, heart failure and dementia - than from cancer. But many terminally ill non-cancer patients cannot access hospice services as Róisín Ingle reports in Weekend Review today. Some 12 counties have no hospice facilities and there is a national shortage of beds and care staff. But that may be about to change. A joint report by the Health Service Executive and the IHP has recommended that palliative care be extended to include the three other medical conditions. And end-of-life care should be available not just to cancer patients but to all who need it irrespective of their illness. This should mean more equitable access to these services.
It also makes financial sense. International studies show that it costs less to treat patients in hospices than hospitals. More importantly, hospices offer respite for the terminally ill. And, as one patient has said: the hospice experience "helps me to live with cancer rather than die with cancer".