2 days ago
'Nursing Home scandal reminds us Ireland doesn't do death well, we outsource it'
During my father's second year of being cared for in a nursing home, I bumped into one of his old neighbours.
Having been told he was still doing OK, she ruefully observed: "Yes, they keep you alive forever in those places."
It was clear from her tone she didn't think that was necessarily a good thing.
As it turns out, they don't. My father passed away in the care of the same home some time later.
Cruelty of circumstance meant he was also alone when his time came, despite several near-misses when family were summoned.
As a nation we love the notion that we "do death well." But in fact, as a culture and society, we have outsourced it. To health professionals and mainly immigrant workers.
The blame for that should not be laid at the door of families.
Our society and our health system have both evolved to make it almost impossible for the growing ranks of the old and infirm to choose to die among their own.
Especially those whose mental capacity has failed them in the cruellest of all diseases as it had my father.
Full time care in the nursing home sector was what the system prescribed as it does for many. Being cared for out among the living world with such a high level of health needs is simply deemed not a viable option.
We are seeing the high price for that solution again this week as the spotlight falls on what can go wrong when a society outsources care.
An undercover RTÉ documentary witnessed shocking treatment in two nursing homes with residents crying out for help, left in soiled clothes and being incorrectly handled.
One of the cruellest impacts of the Covid pandemic – and our response to it – was that so many were condemned to die alone.
That policy of keeping the dying apart from loved ones is a dark chapter we still haven't summoned the stomach to look back upon.
It was a horror captured vividly in one iconic image of a brother staring in a window at his dying sibling in the bed beyond the parting glass.
It led to pledges that if we learned just one thing from it all, we would change a system where the old and dying were communally housed away from the rest of us.
Five years on, it's a pledge that has been largely forgotten.
We still await a statutory right to be cared for at home. We remain eight million hours short of a viable home care network. We shortchange community and voluntary sector workers.
So maybe what is needed now is something more radical. To once again "make death everyone's business" as called for by a recent Queen's University study - Fostering Compassionate Communities: A Call to Transform Caregiving, Dying, Death and Grieving on the Island of Ireland.
The paper reminds us that "historically across this island, the role of caring for people through serious illness, dying, death and grief was centred in the community. Many people in society now view the responsibility for dying and death as that of healthcare professionals."
The authors advocate developing an approach known as 'Compassionate Communities' - the idea that we all share a responsibility to care for each other physically, emotionally and socially to the end.
Community structures and networks would get involved in "spending time with the dying, sharing laughter and tears, offering practical support, and simply showing compassion and care."
The community becomes integrated with health professionals and care services to unleash what the authors call a wealth of "untapped compassion", adding that: "Achieving a 'good death' at home requires sufficient support for carers, effective coordination with healthcare professionals, and the active involvement of the wider community."
There are already many good examples of this kind of voluntary superpower across the country. But if they are joined up with a vision from Government and resourced with funding they could transform how we experience death. And life.
The notion that we do death well became another casualty of the pandemic. What we actually did well was hiding away from the reality of it.
To borrow from the old African proverb, to really do death well, that takes the whole village.
