End-of-life care is gradually being extended beyond cancer patients by the Hospice Movement, which is working on opening it up to sufferers of renal failure next year.

A relatively new subject, palliative care originally focused on cancer, but this was eventually considered a social injustice by the World Health Organisation. Hospice Malta took that idea on board, recently opening up its services to patients suffering from organ failure.

So far, it is catering for cases of heart and respiratory failure but it plans to start admitting kidney patients too next year.

“It is a gradual process because we wanted to gain experience and need finances and human resources. We have to be sure our professional staff is well trained in these areas,” Hospice Malta chairman Vincent Zammit said.

There is indeed such a thing as a “good death” and the mission of Hospice Malta, set up 22 years ago to take care of patients where cure is no longer possible, is to achieve that for them.

“We are now working on an outpatient unit and studying the poss-ibility of an inpatient hospice to complement Mater Dei Hospital,” Dr Zammit said.

General manager Antoinette Shah said it was about time Malta had an inpatient hospice “like there are all over the world”.

Its aims would be symptom control, respite care for the family, and to cater for patients who neither want to die at home nor in an acute hospital but with dignity in a wellrun hospice.

Abroad, she said, such a “noble service” was provided by the government of the day. In some cases, families panicked when a loved one was dying at home, while the patient often did not want the family to be afraid, or preferred to die in a safe and comfortable environment.

Hospice Malta currently operates a “limited” day centre and provides free services, equipment and professional visits to patients’ homes. But its proposed outpatient unit would serve as an “outing” and offer social activities, including physiotherapy and music therapy.

“It would be a far cry from homes for the elderly, ensuring that the patients would be active until the end,” Ms Shah said.

“Death may be certain but no-one wants to die. Hospice professionals help patients and their families to prepare for that day and experience a good death.”

Psychological Issues – Enhancing the Quality of Life was the theme of Hospice Malta’s annual conference, which was held at the Dolmen Resort Hotel yesterday.

Many patients often found the emotional side of a serious illness the most difficult, said Barbara Monroe, a social worker for 35 years and chief executive of London’s St Christopher’s Hospice.

“We need to restore death as part of life because only when we do that can we live until we die,” she said.