Dying Matters chair addresses Irish conference on dying
Professor Lakhani, Chair of the National Council for Palliative Care (NCPC) and Dying Matters, and a practising GP, spoke at the Irish Hospice Foundation’s (IHF) Primary Palliative Care Conference 2014 in Dublin on 15 May. The theme of the event was 'living and dying well in the community'.
Professor Lakhani (pictured above, on the left, with Sharon Foley, Chief Executive of The Irish Hospice Foundation, Dr. Paul Gregan, a GP and consultant in palliative medicine, and Minister for Primary Care Alex White) spoke to the audience about the importance of making end of life care choices early, rather than leaving them until you're too ill to make decisions.
He said: “People die every day. You only die once; make it a good death. Doctors have a key role. Doctors and society need to start the conversation. People plan their pregnancy and get a birth plan but dying people don’t. But even doctors find it hard to start conversations. They avoid discussions on the most needed conversation of all. But a Kings Fund survey of doctors found that 75% of GPs acknowledge they had a key role in end of life care.
"We need to shift the focus from cure and intensive treatment which can be futile to the palliative and supportive care approach to an ageing population with long-term conditions. GPs need more training and some skills acquisition to both identify and support dying patients.”
Professor Lakhani said that after years of most people dying in hospitals in the UK, more are now dying at home. He explained that a mismatch still existed in the UK with around half of people dying in hospital despite the fact that 70% of people wish to die at home. This was down to not identifying people at being at the end of their lives and misdiagnosis. But a lot could be done to change the situation, including early identification and early advance care planning.
Professor Lakhani said: “The role of palliative care is essential in improving care and quality of life. Doctors can bring death back into people’s homes which is giving people choice, promoting their autonomy and giving people what they need.”
Some 29,000 people die in Ireland each year. Research shows that most Irish people want to die at home, but in reality just one in four does so. The three key things that people worry about most at end of life are pain, being a burden on their family and being alone.
The Irish Hospice Foundation Think Ahead initiative, part of The Forum on End of Life, encourages people to talk about dying and to say what their preference is in the event of emergency, serious illness or death.
Also speaking at the event was Dr Paul Gregan, Chair of the National Steering Committee on Primary Palliative Care, who said that just 10% of deaths in Ireland are sudden and unanticipated, which meant "nine out of 10 deaths can be planned". He continued: "Planning such care is eminently do-able for a modern healthcare system. With often prior knowledge of an individual patient, his/her background, medical history, and wider psychosocial perspective, primary care professionals are well positioned to provide excellent care to those expected to die imminently or soon.”