Saturday 21 April 2018

'The nursing home pulled heaven and earth apart to get her to the beach' - one woman's dying wish fulfilled

This week, Independent.ie is running a series on some experiences Irish people have had around end of life in Ireland. Here, two professionals who work with the Irish Hospice Foundation, share their experiences

A woman in an Irish nursing home wanted to go to the beach to have an ice cream before she died.
A woman in an Irish nursing home wanted to go to the beach to have an ice cream before she died.
Geraldine Gittens

Geraldine Gittens

“People ask for very simple things. We sometimes imagine people would ask for the moon. They don’t. They ask for simple things. They ask for the sister they haven’t spoken to.”

“They ask to make a will. To go away on the holiday they never had. They say ‘I want to see the dog’. Sometimes the dog can be really important to them.”

Bryan Nolan, a communications and development coordinator with the Irish Hospice Foundation (IHF), runs workshops on loss and bereavement.

He trains staff in hospitals and residential settings in things like how to communicate with people with dementia or how to deliver bad news to terminal patients.

Read More: 'Tough s**t, join the club’' - inspirational mother-of-three on living with 'pain in the ass' illness 

“In my experience, people don’t ask for the moon [when they’re told they’re at the end of life stage],” he tells Independent.ie.

“One woman in a nursing home wanted to go to the beach to have an ice cream. [Her nursing home] literally pulled heaven and earth apart to get her to the beach. People do extraordinary things.”

“The only way these (wishes) can happen is if there’s honesty, and if we ask people what is going on for them at the moment.”

“People’s biggest fear is, am I going to be in pain? And am I going to be on my own? But unless we’re actually giving people the information that the end is drawing close, we’re never going to have those conversations.”

He added: “The stark reality is that when you’re dying in Ireland you can be the loneliest person in the world because everybody is going to be talking about you, but nobody is talking to you. We end up isolating the one person we don’t want to isolate."

Adrian O’Grady, station officer at Tallaght fire station, is a complicated grief therapist with the IHF and runs workshops for emergency frontline staff on how to deal with bereaved families.

Every day, fire officers and paramedics encounter a death, and often they have to inform a family member of this death.

“We’re getting everything from Sudden Death Syndrome, right up to senior citizens dying and everything in between, from sudden traumatic deaths and people dying in their sleep.”

“It’s very hard for a fire fighter to go from the rescuer mindset to a supportive mindset.”

“If you get the breaking bad news right, you start the grieving right. If you get it wrong, you’ll traumatise a person’s grief.”

It’s vital for Dublin Fire Brigade’s crew to have proper training in how to help families, Adrian explains.

“We looked at what the areas of stress are for fire fighters and paramedics, and one of the major stresses is breaking bad news, and we devised a breaking bad news lecture series.”

“Members of the public depend on us to help them and support them at their worst moments, and it’s up to us to do it professionally. There was a gap in the learning, and thanks to the Irish Hospice masters programme, I feel that we’ve filled that gap.”

“We’re more aware of trying to get their family around and what the supports are that they need, the priest, whatever the person might need. We’ll make that call if the time permits us.”

“If it’s sudden infant death syndrome in particular, we’ll slow things down and get all the supports the family needs. When you’re breaking the bad news of a death of a child to a parents, that’s the hardest. You can imagine, the grief goes so deep.”

“Even if it’s obvious [that their loved one has died], they’re still hoping that you’re going to walk in and save them.”

“We don’t like those moments ourselves. We’re born to save lives. We don’t like not rescuing people. To turn around and have to break bad news is difficult for us.”

Fire officers also receive training in how to deal with death, and critical and traumatic incidents. The recent fire in the Metro Hotel in Ballymun was particularly challenging for fire officers, Adrian explains.

“The fire in Ballymun, that is outside the normal - we don’t normally get that type of fire. Especially after Grenfell… going up the steps, we would have been thinking about Grenfell.”

In the past, doctors might have discussed patients’ prognoses with their family members. But now the patient is at the centre of these discussions. Children too who have terminal illnesses are now included too, something that represents a big change, Bryan adds.

“You have a mutual discussion about what’s going on, you check how the person is, check how they’re feeling. And it’s about finding out how to break the bad news in such a way that the person can comprehend it.”

“We’ve done a lot of work with kids over the years. We start with the adults because they know their kids. The evidence is that when kids are included, they do an awful lot better. It’s not scary for them. Children are much more practical than we are, it’s the innocence, they want to know all the details and everything that’s happening.”

Bryan remembers one child who was discussing her prognosis with her doctors before turning to her mum and saying, “mum you need to step outside now”. The child was able to ask all the questions which might have been too painful for her mother to hear.

“These conversations are hugely difficult. In dealing with bad news and talking to people about their end of life, we do need to go gently. If we keep the person at the centre always, we’re not going to go too wrong. Then there’s safety and security and honesty and truth.”

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