Why does access to key people and timely help matter at end of life? Sláintecare is Ireland’s health reform programme, focused on ensuring that healthcare services are timely, responsive, and patient-centred. Its guiding principles stress a patient-centred approach, with timely care available free at the point of delivery. 15 Aligned to this, a key objective of the National Positive Ageing Strategy is to “Promote the development and delivery of a continuum of high quality care services and supports that are responsive to the changing needs and preferences of people as they age and at end of life” . 16 Published more than 10 years ago, the Strategy has not had the investment or resourcing needed to deliver on its ambitions. People at end of life must have access to a reliable, trained and supportive healthcare team who work in close co-operation with each other. This often means access to responsive supports when needed, such as home carers that offer a family respite or 24-7 access to timely information, prescriptions or out-of-hours care. 17 It is essential that the core primary care team (e.g. GPs and community nurses) have an understanding of their responsibilities when caring for a dying person in the community. Currently these types of services are not uniformly available and out-of-hours periods are particularly problematic. There is a need for these to be expanded upon to deliver people the right care, at the right time and in the right place, as is set out in Sláintecare. A study by Irish Hospice Foundation into the experiences of people dying at home identified that poor access to care was a key barrier for them. Participants noted the gaps in continuous care, such as a lack of 24-hour support and weekend support exacerbated the pressures, anxieties, and strain that family/carers often feel. 18 SUMMARY THE AVAILABILITY OF KEY HEALTHCARE STAFF TO PROVIDE SUPPORT QUICKLY IN TIMES OF URGENT NEED IS ONE OF THE MOST INFLUENTIAL FACTORS DETERMINING OLDER PEOPLE’S OVERALL END-OF-LIFE EXPERIENCE. ACCESS TO THESE STAFF SHOULD BE UNIVERSAL, FOR EVERYONE WHO NEEDS IT.
15 Sláintecare , Department of Health, 2017 16 National Positive Ageing Strategy , Department of Health, 2013 17 Deaths at home during the Covid-19 pandemic and implications for patients and services , Nuffield Trust, 2023 18 Dying Well at Home Report , Irish Hospice Foundation, 2023
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Experiences of Older People at End of Life 2025
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