Palliative care improved the quality of life of patients and their families facing the problems associated with life-threatening illness, the conference heard. Photo: Matthew Mirabelli

Hospital patients are often discharged abruptly, sometimes without a discharge letter and barely knowing their diagnosis and prognosis, according to hospice nurse Ruth Garrity.

Speaking at a conference organised by Hospice Malta titled ‘Palliative care for all: the way forward’, Ms Garrity said there was a lack of communication between patients and hospital staff.

“The doctor tells the patient that he’ll refer him to Hospice Malta. The patient immediately thinks, ‘Oh my God, I’m going to die’, and bye-bye hospice. They would not want to approach us because they want to resist death,” she said.

Discharge planning, Ms Garrity explained, was a standard feature of health systems in many countries. It is the process used to decide what a patient needs to move smoothly from one level of care to another.

Effective, timely and safe discharge from hospital reduces the patient’s length of stay, prevents unplanned re-admissions and improves the outcome for the patient in terms of health.

Ms Garrity said she knew of a patient who had been discharged with an open, infected wound and who was now very weak.

We need to train our healthcare professionals in palliative care approaches

He confided to the nurses that it might have been too early for him to leave hospital.

Carers also need to be supported as they may not feel able to properly care for their sick family member, or may have a bad relationship with the patient. “Every family is different. If there was no relationship prior to the patient falling ill, it’s not going to be built up in a few days or weeks,” she said.

“How can we oblige people to care for the patient if no caring relationship existed before?

“And what kind of house would the patient be going to? We currently have a case where seven people live in one room. How can we install a bed there? Is the environment clean enough? If the patient is being discharged with an open wound, does he have access to clean water facilities?”

Opening the conference, Health Minister Godfrey Farrugia said that he held palliative care very close to his heart and end-of-life care was a priority for the government.

Palliative care improved the quality of life of patients and their families facing the problems associated with life-threatening illness, he said.

It could help ease the journey from care and grief towards acceptance and healing.

The National Health Systems report, a strategy for 2015 to 2020, featured palliative care and the new oncology centre would host 16 beds for palliative care.

Further palliative care beds for end-of-life care were being planned by Hospice Malta – Dr Farrugia hoped the Ministry for Health would form a public social partnership with the hospice in this regard.

Community care services also needed to be consolidated as deficiencies led to an increase in admissions to Mater Dei Hospital.

These admissions could be prevented by crisis prevention rather than crisis control.

“We need to train our healthcare professionals in palliative care approaches that do not only focus on pain and symptom control but also emphasise the need for management of other physical, psychosocial, spiritual and inter-relationship issues,” he said.

“Families need to be given the necessary support during the patient’s life and, more importantly, afterwards.”