Majority of bereaved say loved ones received ‘very good’ care

The survey, conducted by the Health Information and Quality Authority (Hiqa) on foot of a recommendation from the covid-19 nursing homes expert panel, was run in mid-2023 and consulted more than 4,500 bereaved family members and friends of people who died between September and December 2022.

While broadly reporting positive experiences of end-of-life care in Irish life, the survey also noted several areas in which care could be improved, notably the quality of continuity-of-care where people were being treated across multiple institutions and locations.

Some 23.9% of respondents answered ‘no’ when asked if there had been good coordination between the different services and staff caring for their loved one in the last three months of their life.

Such care across locations was shown to be very common among people in the final months of their lives, with those who died receiving care in roughly 1.6 locations on average.

Nearly 18% of those asked, meanwhile, said their relative or friend did not get help as soon as they needed it from medical staff when being cared for at home, with that figure falling slightly in acute hospital settings to 16.8%.

That figure was much lower again in nursing homes and residential care facilities at just 7%.

Meanwhile, hospital care was singled out in terms of the quality of support for end-of-life patients’ ‘emotional needs’, for example feelings of worry, anxiety, or generally feeling low.

Some 44% of the 2,737 people questioned as to the quality of that care in hospitals said healthcare staff did not adequately help and support their relative or friend with regard to those emotional needs.

Overall, responses indicated high levels of satisfaction with end-of-life care generally however, with 89% of respondents saying their loved one had received either ‘good’ or ‘very good’ care.

The most positive responses noted in terms of end-of-life care came from bereaved relatives of those who died in a hospice, with almost 94% of those respondents rating that care as ‘very good’.

Just under 11% of deaths considered by the survey occurred in hospice settings.

Industry group Nursing Homes Ireland said it welcomed the survey’s findings, saying it was “heartened” by the responses recorded, while adding an acknowledgement that “work remains in ensuring any shortcomings in end-of-life care are addressed”.

Nearly 30% of Irish deaths occur in nursing homes or residential care, with 39% happening in hospital and 22% at home.

Health Minister Stephen Donnelly, meanwhile, said the survey’s results provide “a positive view” of end-of-life care in Ireland.

He said he recognised however that “there are still areas for improvement, particularly in the areas of integration and coordination of services”, adding that the findings would be used “to inform department policy” with regard to end-of-life care.