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Grief research to help bereaved
[ by www.irishhealth.com]
In Ireland there is a belief that we handle death pretty well. Sorrow is acknowledged. Large attendances at removals and funerals are a sign of concern for the bereaved, and friends and neighbours tend to rally around with gifts and massive amounts of food in an attempt to ease the sorrow.
But the actual moments of death, and the handling of the deceased and their families could do with a lot of improvement, the Irish Hospice Foundation (IHF) believes.
The result is a five-year, €10 million project involving 41 public hospitals nationwide. It is a unique project, never before done in Europe and possibly the world, its organisers say.
And the aim is an ordered and orderly plan for death, dying and bereavement (DDB) in place so every staff member from consultant to canteen assistant knows how to react when a patient dies.
“There are four areas that need attention,” says Paul Murray, one of 10 project co-ordinators across the country. He came to this indirectly through his former work as communications director at Age Action.
"They are: autonomy, communications, design and dignity, and integration.”
Autonomy refers to giving people and their families choice, and listening to and respecting their wishes regarding the manner of their death and the aftermath.
The communications category covers questions such as where people are told of a death, Paul Murray says.
“Is it in a corridor, a broom cupboard; is the person telling the news qualified to do so? Are they telling the right member of the family? And what do you say to children?”
All these issues need to be considered carefully. Children, for example, are often more resilient and able to handle the death of a relative than adults imagine, Murray believes.
Design and dignity are to do with the environment for terminal patients.
“Good design, the light in the room, bed space, accommodation for someone else to stay in the room, can all enormously enhance the death pathway,” Paul Murray says.
"Next issue on the list, integration, means integrated care, with all staff and parties involved in handling a death knowing who does what. It can even extend to matters like sufficient parking for family of the deceased."
Mr Murray makes the point that the Irish have traditionally held respect for the ceremonies around death. But with the pressures of a modern, stretched healthcare service, as well as the factors involved in a multicultural society, work needs to be done so people can die with dignity in a calm environment.
“Thirty thousand deaths occur a year, and 60% of them are in hospitals. That is a lot of people affected, when you consider family members, and also the staff.
“For example, a nurse in her mid-twenties may never have seen a dead child. That would be difficult to handle. Staff need training in how to handle procedures and their own responses.”
Part of the IHF programme is training for hospital staff. If DDB approaches are in place, there is a tangible benefit that translates into social and economic gains, Murray believes.
“What you need is a ‘laptop plan’, as happens in Australia. When someone dies, all a member of staff has to do is consult their laptop for a step-by-step guide to how to act, in a number of situations. We would like to see such a procedure drawn up and standardised.”
Under the project’s current structure there is a steering committee, comprised of representatives of the IHF, medical professionals, gerontologists and HSE staff. This is overseeing the project, and the first step is drawing up standards for behaviour, which has a dedicated committee.
An apparent new awareness of the essential importance of bereavement support and planning is also demonstrated at Beaumont Hospital in Dublin.
Beaumont’s bereavement care centre is led by Dr Trish Walsh, and follows a programme designed by social worker Siobhan O’Driscoll. This is described as a whole-hospital approach. It includes training and support for staff, as well as giving the bereaved information about subsequent services in the community.
A recent study done for the Beaumont service by Trinity College researchers found that for every death, an average of 10 other people are deeply affected.
Beaumont has signed a memorandum of understanding with the IHF to take part in the Hospice Friendly Hospitals Programme.
And a special service run for bereaved parents is gearing up for a new phase in the New Year.
Anam Cara, which started two years ago when a number of people who had lost children came together, is expanding and hopes to help parents all over Ireland.
Sharon Vard of Anam Cara said the organisation offered support and the company of others who had suffered a similar experience.
“We come from all walks of life, and are open to everyone,’’ she said. “We don’t offer counselling as such – the nearest model to us would be the organisation Compassionate Friends, but without any religious link.”
Ms Vard said Anam Cara particularly wanted to alert people to what other services did exist for parents of any age who experienced the death of a child.
The website is www.anamcara.ie, and the postal address is c/o Sunshine Homes, Leopardstown, Dublin 18.
|Anonymous Posted: 14/12/2007 09:44|
|In the hspital where my father died, I found the care staff to be wonderful. However 5 days after his death we recieveda bill for his care - I thought this rather cold and clinical on the part of the Admin staff.|
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