A night nursing service for people with a non malignant illness
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Outlines the Irish Hospice Foundations Nurses for Night Care Programme and how the service supports people dying at home with illnesses other than cancer
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A night nursing service for people with a non malignant illness
- 1. A NIGHT NURSING SERVICE FOR PEOPLE WITH A NON-MALIGNANT ILLNESS Sarah Cronin, Deirdre Shanagher & Marie Lynch, RCSI 35th Annual International Nursing & Midwifery Research and Education Conference, March, 2016
- 2. Today… • Dying in Ireland • Dying at Home • The NNC Service • Trends in use • Comparative analysis
- 3. Background
- 4. Death and Dying in Ireland
- 5. Irish Attitudes to End of Life
- 6. “ While a good death at home may not be feasible or desirable for everyone, it could undoubtedly be a reality for many more people if we nurture the services to support it” (NHS, 2012)
- 7. Factors which can enable a person to die at home Personal and Demographic Factors • Carers • Gender • Age • Marital Status • Level of Education • Presence of Advance Care Plan • Socioeconomic Status Disease-related factors • Diagnosis • Co-morbidities • Symptom management • Pain Environmental factors • Urban vs rural location • Availability of local services and supports – GP, OOH, SPCT • Hospital and residential care beds • Access to equipment • Formal supports
- 8. NNC Service
- 9. NNC use 2015 per illness category 0 20 40 60 80 100 120 140 160 MND Other Neurological illness Dementia Inc Alzheimers Heart Failure Other Circulatory Respiratory Renal All other Jan-Dec Jan-Dec
- 10. NNC Service: Trends in Use 308 208 728 424 270 950 462 341 1232 570 407 1473 742 548 1734 0 200 400 600 800 1000 1200 1400 1600 1800 2000 No of Referrals No of People in Receipt No of Nights Delivered 2011 2012 2013 2014 2015
- 11. Irish & UK Cancer & Non Cancer data 2011-2013
- 12. Irish MDS Data with IHF NNC Data 2013
- 13. Conclusions • Not all people referred to SPC services require the NNC service • Awareness raising about the service is required • Appropriate use of the service should be exercised • Comparison of data over a longer period of time is required to identify more trends
- 14. Next steps • Illness specific analysis of data • Dementia – completed and report due in April 2016 • Heart Failure commencing April 2016 • Awareness raising with SPC teams
- 15. Contact Information Sarah Cronin, Dementia Development Officer sarah.cronin@hospicefoundation.ie Information on NNC Service: http://hospicefoundation.ie/healthcare- programmes/palliative-care/palliative- care-for-all/night-care/
Editor's Notes
- Report of the National Advisory Committee for Palliative Care in 2001 identified that people with non malignant conditions should have access to SPCT. Palliative Care for all – HSE and IHF in 2008
- Around 30,000 people die each year in Ireland
- Presence of a family carer who is willing and able to provide care is one of the strongest predictors in achieving a home death Expressing a wish to die at home Cancer diagnosis more likely to achieve a home death (almost doubles odds) Longer term functional disability is associated with more home deaths (time to plan etc) GP awareness of a person’s wishes a key factor Provision of SPCT in the community almost doubles the odds of person being able to die at home. Timing of referral is critical Living in area where there are hospital and/ or care home beds available increases the likelihood of dying in one of those locations.
- Chart looks at the number of referrals, the number of people in receipt of the service and the number of nights delivered, all of which are rising each year. 548 people accessed the service last year with 1734 nights being delivered across the country.
- NNC data compared with MDS data and data available from the NCPC UK Chart shows number of people with and without cancer that accessed SPC services from 2011 to 2013 in Ireland and the UK. The number of people with non malignant illness accessing specialist palliative care services is rising. Across the 3 years Non-malignant illnesses accounted for between 16 and 17% of those that accessed SPC services in the UK and between 19 and 26% in Ireland.
- The demand on the IHF NNC service is increasing year on year. There is variance in both referrals to SPC services and the IHF NNC service in 2013. Some LHO areas have higher referral rates to SPC and to the NNC service that is not consistent with MDS information nor does it follow trends in the UK.