Sir, – Fiona Reddan's article "Funeral costs – is it time to plan ahead?" (Business, March 22nd) raises many interesting points about attitudes to dying, death and bereavement and the whole population effect of dealing with our mortality.
Healthcare costs increase towards the end of life with proximity to death, rather than age, resulting in very high use of health service resources. It is estimated that up to 12 per cent of the total healthcare budget is spent on care in the last year of life.
Higher costs also have a significant impact on people approaching end of life and their carers. Research on the economic impact of bereavement shows costs include funeral expenses; living, medical and therapeutic expenses; and loss of benefit and household income. The subjective experience of financial hardship is empirically linked to psychological distress and poorer quality of life for bereaved people. Money has a psychological and security value as important as its fiscal worth.
The Irish Hospice Foundation strongly advocates for the provision of comprehensive specialist palliative care across all care settings.
This offers comfort and dignity and has proven cost benefits.
Welcome advances in medical treatment mean we have begun to think about dying, death and bereavement as something for healthcare professionals to fix or manage. It is not the sole responsibility of one service. We are all responsible. There is ample evidence of both the human and economic cost of poor, unplanned or unresponsive care and social services at end of life and in bereavement.
We believe that a population-wide approach is required to financial, legal, administrative, educational and cultural issues relating to end of life. Results are awaited of a welcome initiative by the Taoiseach in 2015 in asking Senator Marie Louise O’Donnell to map the interaction of all government departments to the public in relation to end-of-life issues.
As well as providing responsive and appropriate healthcare, the next government must take a strategic, cross-departmental approach to issues at end of life.
The Assisted Decision-Making (Capacity) Act 2015 must be commenced immediately. The Government should lead a debate encouraging people to acknowledge the need for future planning, to support them in loss and enable them to make important decisions for themselves – to plan ahead, perhaps using the Irish Hospice Foundation’s “Think Ahead” form (thinkahead.ie ).
Then we can all get on with the business of living. – Yours, etc,
ANGELA EDGHILL,
Advocacy Co-ordinator,
The Irish Hospice
Foundation,
Morrison Chambers,
32 Nassau Street,
Dublin 2.