The death of a child is one of the most traumatic events that can befall any family, and this applies whether it occurs in a healthcare setting or elsewhere. It is important to support affected families in every way that we can. There is a wide range of bereavement support and information services available and significant work is already underway to standardise these services so as to provide appropriate support for families who find themselves in this unfortunate situation.
The 2001 Report of the National Advisory Committee on Palliative Care recommended that bereavement support should be an essential part of all specialist palliative care programmes and should be available in all settings where specialist palliative care is offered.
The HSE has recently published the Palliative Care Competence Framework which sets out the core competencies as to the required knowledge, attitudes and skills across 10 different health care disciplines. One of the areas of care addressed is Loss, Grief and Bereavement, and through its implementation the Framework will ensure that the provision of bereavement support is enhanced across all care settings, including the community, nursing homes, hospitals, and specialist palliative care units.
Another palliative care service improvement being undertaken by the HSE is the compilation of Towards Excellence in Palliative Care, which will
meet the requirements of HIQA’s National Standards for Better Safer Healthcare. This consists of 8 Quality Assessment and Improvement Workbooks which will be used to assess specialist palliative care services against the national standards. One of the Essential Elements is in relation to maximising the quality of life and support in bereavement, including the development of bereavement plans.
Palliative Care for Children with Life limiting Conditions in Ireland – a National Policy (DoH 2009) recommends that bereavement supports for children’s palliative care should be developed to defined levels and encompasses child, adult and family support. A National Network for Children’s Bereavement Services is being developed by the Irish Hospice Foundation in partnership with the Family Support Agency. A progress report on the initiative will be presented later this year to the HSE's National Development Committee for Palliative Care.
The HSE recently conducted a survey of acute hospitals on palliative and end of life care, including bereavement services, and the responses received will be analysed as soon as possible.
HSE national guidelines for bereavement care following pregnancy loss and peri-natal death have been developed. They will be issued for public consultation this week with a view to publication and launch in the Autumn.
The role of the Children’s Outreach Nurse is to support parents not only while their child is ill, but also into bereavement. The families are also supported by palliative home care teams who are experienced in the provision of bereavement support and who can refer parents with complicated grief to appropriate services.
The HSE Directory of Bereavement Support Services ‘You are not Alone’ published in 2013 includes information on bereavement and other support services. Organisations such as the Irish Cancer Society and Citizens Information Services provide bereavement support and information as part of their services. Parents also have access to local bereavement support services provided across the country.
The scheme of grants for marriage, child and bereavement counselling services has been managed by Tusla, the Child and Family Agency, since its establishment in January 2014.
The scheme is open to voluntary organisations that provide marriage and relationship counselling services, helping people to deal with difficulties they experience in their relationships, counselling services to children and bereavement counselling and support to families on the death of a family member. A key feature of the scheme is that it makes counselling available to those who could not otherwise afford it.
While there is of course a place for formal national policies, the most immediate priority in this area has been to develop relevant front-line services to the maximum possible extent within available resources. However, I have asked the HSE to consider whether the Executive’s objectives and priorities in the area of bereavement services are sufficiently consolidated and clear at this point in time, and to revert to me as soon as possible with the outcome. I will consider the position further at that point.
