\u201cMany are reluctant to discuss palliative care due to fear of upsetting others or because death is culturally seen as a failure,\u201d according to an AIIHPC research document. \u201cThese taboos are a major barrier to engagement with both palliative care and advance care planning.\u201d<\/p>\n
Common misunderstandings about palliative care do not help, either. It tends to be seen as something that happens in a hospice, during the final days of a person dying from cancer. In fact, specialist palliative care teams work with anybody who has been diagnosed with a life-limiting condition, and not just in hospices, but also in acute hospitals, private houses and nursing homes. They look after not only the patient concerned, but their families, too.<\/p>\n
\u201cWe don\u2019t go away,\u201d was the assurance given to Aed\u00edn Gillespie when she was leaving St Francis Hospice in Raheny<\/a>, Dublin<\/a>, the day her husband Frank died there at age 51. Her voice cracks with emotion 11 years later, as she recalls those words and how staff supported her and their two children, Billy and Frankie, aged just nine and eight respectively, through that very difficult time.<\/p>\n \u201cPeople would ask me about the hospice, and I\u2019d say, \u2018they saved my family, which is an odd thing to say because, obviously, Frank died. But they saved the rest of my family,\u201d explains Gillespie. Before her husband was diagnosed with metastatic cancer at the age of 50, her understanding of palliative care was as symptom control and giving people dignity in death.<\/p>\n \u201cI knew I would get help with the children,\u201d she says. \u201cBut I didn\u2019t realise how much work they [palliative care staff] actually do for the family afterwards.\u201d<\/p>\n She believes the fact her children say they don\u2019t remember their father\u2019s unusually long, six-month stay in the hospice as a difficult time is testament to the care they all received there. Frank\u2019s room was their private domain; on arrival he hadn\u2019t liked the layout, and the staff unquestioningly reorganised it immediately to his preference.<\/p>\n \u201cWith the kids being that young, we were able to have movie nights and pizza nights. We\u2019d go after school and they\u2019d do their homework.\u201d<\/p>\n [\u00a0Palliative care: \u2018I\u2019ve had a good life.. a lot to be grateful for. But I\u2019d still rather live\u2019Opens in new window<\/a>\u00a0]<\/p>\n It\u2019s the little things that Billy and Frankie recall, such as nurses sneaking them ice-creams and turning a blind eye when they clambered aboard their father\u2019s wheelchair for a spin down the corridor.<\/p>\n The more prepared people are for the death of a loved one, the better their outcomes in bereavement, says Niamh Finucane, co-ordinator of social work and bereavement services at the hospice. With young families, the main aim of social workers is to enable adults around the children to support them as much as possible.<\/p>\n \u201cThey\u2019re the ones who are there at bedtime or over a weekend – the tough questions come when they\u2019re in the middle of cooking dinner. To tell them how children might be thinking or feeling, or things to look out for, and to upskill them, is going to be the best in the long run for all of them.\u201d<\/p>\n St Francis Hospice provides palliative care to 2,300 patients and families every year. Some 63 per cent have a cancer diagnosis; 37 per cent have other life-limiting conditions. While the hospice has 43 in-patient beds between centres in Raheny and Blanchardstown, 70 per cent of its service is delivered in the community, either in people\u2019s homes (including residential centres) or through its outpatient service.<\/p>\n \u201cWhat we\u2019re always aiming to do is to try and prevent future difficulties,\u201d says Finucane. Families may think they are protecting children by not telling them about a family member\u2019s life-limiting diagnosis, but research shows that children generally want to know what\u2019s going on and to have a chance to be involved in care. For younger ones, that might be simple things such as bringing a drink of water to the person, or perhaps drawing a picture to try to make them happy, she suggests, while older children could contribute to hands-on care. The trajectory of an illness, or how a family is coping, may determine how long the hospice social care team has to work with children in the lead-up to bereavement.<\/p>\n \u201cSometimes we\u2019re involved in conversations months out from the death, where we can help parents plan the memory work that they do, as well as the communication with their children around changes and what\u2019s happening. Other times, we\u2019re trying to do that in a much shorter period of time because nobody could really face it, until it got to that very end stage.\u201d<\/p>\n It\u2019s normal for people to have a tough time after someone dies, in the sense that grief is a normal response, she says. \u201cBut it\u2019s trying to not compound that with people not being prepared or not knowing what was going to happen.\u201d<\/p>\n Palliative care consultant Dr Regina McQuillan agrees that we definitely handle death and its aftermath very well in this country. She also believes there is \u201cfairly good support\u201d within the health service when it is recognised that people are dying, although \u201cthere\u2019s lots of room for improvement\u201d.<\/p>\n \u201cOne thing I think that probably we\u2019re not as good about is maybe that idea of thinking ahead about, if you have a serious illness and you\u2019re likely to die, what\u2019s likely to happen or what might be important to you.\u201d The Irish Hospice Foundation (hospicefoundation.ie)<\/a> offers a very helpful Think Ahead planning pack for this. <\/p>\n [\u00a0Palliative care is about so much more than end of lifeOpens in new window<\/a>\u00a0]<\/p>\n While palliative care recognises that an underlying illness cannot be cured, \u201cit\u2019s not about doing nothing either\u201d, she stresses. \u201cIt\u2019s about trying to manage the other problems that people might have. That\u2019s why somebody might be simultaneously receiving palliative care, but also needing to go to hospital for antibiotics by drip.\u201d<\/p>\n For some people who\u2019ve cared for people a long time, there can be a certain amount of relief [after death], and that\u2019s a very difficult one<\/p>\n \u2014 \u00a0Aed\u00edn Gillespie<\/p>\n It\u2019s important to get the right balance and not under-treat a patient\u2019s problems because they have an incurable illness. The judgment call can be difficult, she says, on whether or not medically treating an issue will help.<\/p>\n Sometimes patients are very clear themselves, she says. They may have been in and out of hospital for successful treatment of infections but feel that, as their overall quality of life is not improving, they would prefer not to go back to hospital.<\/p>\n There are insufficient specialist palliative care beds in the country, and there are challenges in providing outpatient specialist palliative care too, she says. However, \u201cnot everybody with a life-limiting illness needs to see specialist palliative care or needs to be in an in-patient hospice unit\u201d. In addition to specialist teams, other nurses and doctors, such as GPs, oncologists and geriatricians, have palliative-care skills.<\/p>\n \u201cIn Ireland, we are lucky enough that the Government is committed to funding and developing specialist palliative care services,\u201d she says. But there are \u201cvery clear\u201d deficits in staffing and services around the country that need to be addressed. State spending on palliative care is projected to reach \u20ac179 million this year, an increase of 13 per cent from \u20ac155 million in 2024.<\/p>\n On the idea that death of a patient can be seen as a failure, McQuillan is concerned that sometimes people feel if \u201csomebody\u201d, be that a doctor, family member or the patient themselves \u201chad tried harder or fought more, they might have been able to beat it\u201d. Unfortunately, she says, such a scenario is not possible with life-limiting diseases. <\/p>\n McQuillan has, on behalf of the Irish Palliative Medicines Consultants Association<\/a>, opposed moves to decriminalise assisted death for terminally ill people in certain circumstances. The Voluntary Assisted Dying Bill 2024 has been stalled since the change of government.<\/p>\n Working in this field, she says, \u201cwe are dealing with people who have illnesses that in some countries would make them eligible for assisted suicide or euthanasia\u201d. She sees a danger here not just for individuals, but also for wider society. \u201cIt creates the idea that for some situations, death is a solution to some problems. There is an argument to say that maybe assisted suicide and euthanasia is not a healthcare issue. It\u2019s a societal response to distress, and maybe this needs to be outside of healthcare entirely.\u201d <\/p>\n![\"Aedín](\"https:\/\/www.newsbeep.com\/ie\/wp-content\/uploads\/2025\/09\/EFBHZUZ64BAJJLLKR6T454W5ZM.jpg\")
Aed\u00edn Gillespie, a bereavement volunteer at St Francis Hospice whose husband died in the hospice. Photograph: Dara Mac D\u00f3naill <\/p>\n![\"Niamh](\"https:\/\/www.newsbeep.com\/ie\/wp-content\/uploads\/2025\/09\/KK5DZSLZOVFUDD4OBC2NR5U6GI.png\")
Niamh Finucane, co-ordinator of social work and bereavement services <\/p>\n![\"Palliative](\"https:\/\/www.newsbeep.com\/ie\/wp-content\/uploads\/2025\/09\/HCAORI2BEZLL3N47OUC5E677HI.jpg\")
Palliative care consultant Dr Regina McQuillan. Photograph: Dara Mac Donaill <\/p>\n
![\"Billy](\"https:\/\/www.newsbeep.com\/ie\/wp-content\/uploads\/2025\/09\/TH3PNR653NCEXHUUWUOVLWN75A.JPG\")
Billy and Frankie Gillespie with their mother Aed\u00edn. They are holding paintings of themselves painted by their late father Frank while he was in the hospice <\/p>\n