FAQs about Hospice Care
At what point in an illness is someone referred to hospice care, and why?
When someone is referred to hospice/palliative care, it generally means it is no longer expected their illness can be cured. This does not necessarily mean that death is imminent. Since hospice/palliative care professionals are experts in the management of pain and other symptoms, a person may spend a short time in a hospice to determine the best treatment for their symptoms. Admission to a hospice may also be for a period of respite, after which the patient may return home again.
People often feel frightened when they hear they or their loved one has been referred to hospice/palliative care, but afterwards may wish it had happened sooner.
Early Referral to Hospice / Palliative Care
Early referral allows for anticipation and better management of symptoms and potential problems. It also allows for emotional and psychological support for the family. It generally results in improved quality of life for a longer time for both patient and family. Hospice care is often appropriate sooner rather than later.
Is hospice care available to everyone?
Unfortunately, not. Hospice care and expertise has traditionally developed around needs of people with cancer. For this reason access to services for people with other illnesses has been limited. This is now improving, particularly in conditions such as Motor Neurone Disease and Multiple Sclerosis. Access continues to vary dependent on location.
The Irish Hospice Foundation’s Palliative Care for All Programme explores how hospice/palliative care can be extended to everyone who needs it, regardless of the nature of their illness
How can I get my relative or friend into a hospice, or arrange for hospice home care? Can the Irish Hospice Foundation help?
To be admitted to a hospice or to access hospice home care, a patient must be referred by their family doctor or hospital consultant, who will generally be familiar with the procedure and the referral form which he/she will be required to complete. If the matter has not yet been raised and you are wondering about it, do not be afraid to bring it up yourself with the doctor, nurse or other healthcare professional concerned.
If you wish, you could also contact your local hospice, home care service or health centre for advice – but a doctor’s referral will always be needed before a patient can be admitted to a service.
The Irish Hospice Foundation cannot assist with individual patient admissions. We work for the development of hospice/palliative care generally in Ireland, but we do not run or manage hospices.
Who pays for hospice care?
Hospice care is provided free of charge, regardless of the patient’s or their family’s circumstances. Where patients have private medical insurance, their insurer may be asked to contribute towards the cost of their care.
Where is hospice care provided, and by whom?
Hospice/palliative care is provided:
- in hospices
- in people’s own homes by Clinical Nurse Specialists (often referred to as ‘home care nurses’) working in cooperation with GPs and public health nurses
- in general hospitals, by the hospital’s specialist palliative care team
- in community hospitals and nursing nurses, by home care nurses working in cooperation with GPs and public health nurses
Is there a hospice in my area?
There are nine inpatient hospices in Ireland, located in counties Dublin, Kildare, Cork, Galway, Limerick, Sligo and Donegal. Click here for details of all local services, listed by county.
What happens if there isn’t hospice in my area?
You may be able to access home care, provided by home care nurses working together with family doctors and public health nurses. As noted above, hospice/palliative care is also provided in general hospitals, and in some areas, in designated beds in community hospitals and nursing homes. See also: How do I access hospice/palliative care? and Is hospice care available to everyone? above.
What is meant by ‘specialist palliative care in the community’?
”Specialist palliative care in the community’ is another term for home care – the care provided to people with terminal illnesses in their homes, or sometimes in a community hospital or nursing home. Overall responsibility for monitoring and supervising the medical care of home care patients rests with the GP. The patient is cared for by home care nurses working in cooperation with the GP, the public health nurse and sometimes other professionals (see also next question, below).
What are specialist palliative care teams?
Specialist palliative care teams are found in hospices, in many general hospitals and in the community. The team is led by a Consultant in Palliative Medicine and may include doctors, nurses (including Clinical Nurse Specialists), social workers, physiotherapists, psychologists, chaplains and others who are able to provide support to those nearing the end of life and those who are important to them.
What is a Clinical Nurse Specialist (CNS) in Palliative Care?
A CNS is a nurse who has received specialist training in a particular area. A CNS in Palliative Care will have trained in all aspects of this specialty, including symptom assessment and relief. He/she may work as part of a palliative care team in a hospice or general hospital, or may care for patients in the home, in a nursing home or other healthcare setting.
We would like to keep my relative at home for as long as possible, but it is becoming very difficult. What help is available?
If your relative is not yet receiving hospice home care, you should speak to the GP or public health nurse involved in the patient’s care care to enquire about having him/her referred to the local home care service. See also: How do I access hospice/palliative care? and Is hospice care available to everyone? above.
If you are a family carer looking after someone in the home, you be interested in our Supporting Carers section.
What about night-time care?
Cancer patients who are being cared for at home and who are approaching the end of life can access up to 14 nights’ nursing care, provided free of charge by the Irish Cancer Society (ICS). Thanks to ongoing Irish Hospice Foundation funding, this service is now extended to non-cancer patients also, provided they are already under the care of a hospice/palliative home care service. Referral for night nursing for non-cancer patients can only be made by the home care service; referrals cannot be accepted from GPs, public health nurses or family members.