Why all over-70s should have a chance to talk about end-of-life care with their GP

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One Small Change: Prof Brendan O’ Shea, a public health and primary care specialist, on a simple way to improve Ireland’s health system

End-of-life care: My concern is that people are not yet discussing what they would like to happen consistently and, for most people, in a timely manner. Photograph: iStock/GettyYou can email health@irishtimes.

About 35,000 people die in the Republic of Ireland each year. As a GP, it appears to me that some people are very well prepared for what is usually a predictable event, others are somewhat prepared, and a substantial minority die full of uncertainty and in distress. One factor that I believe would make a difference is if individuals who are dying have a good opportunity to discuss their end-of-life-care preferences. If this can happen, preferably before they become terminally ill, then it is more likely that their care preferences are clarified and acknowledged. When these issues are discussed openly, it also allows important issues between them and their family and friends to be resolved.

As a society we have already given much thought to this. One of the requirements for clinicians from the Assisted Decision-Making Act 2015, which is just about to become law, is that GPs, medical consultants and nurses now have a duty of care to discuss with patients their end-of-life-care preferences, to document these and, as far as possible, to ensure they are acted on.

Many doctors are getting better at having these discussions. But one small change that could make a difference would be to ensure that all individuals approaching the end of their life would have an opportunity to have this discussion, and preferably well before they become acutely unwell, while they are better able to engage in the discussion.

 

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Get Michael o Leary to run it.

Not charging for using it would be a way to start

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