Dark cloud overshadows a high quality of care in Shaen Hospital

My sister passed away in a nursing home on December 22, last year shortly before her 91st birthday. Maureen had been in St. Brigid’s Hospital, Shaen, Portlaoise for seven years.

My sister passed away in a nursing home on December 22, last year shortly before her 91st birthday. Maureen had been in St. Brigid’s Hospital, Shaen, Portlaoise for seven years.

She lived her last months totally oblivious to the outpourings and shock throughout the country of the abuse revelations at Mayo’s Swinford residential care home, Aras Attracta.

She died peacefully and with dignity, soothed and untroubled as she drew her last breath. We are forever beholden that Maureen’s specific healthcare needs were attended to and managed with such professionalism and humanity.

We know that coming to terms with a loved one’s illness is challenging enough without the menace of Shaen’s closure being announced in 2011. This caused upset and serious concerns for us and other families.

However at no stage did the impending closures overshadow the care and commitment to Maureen’s comfort and wellbeing – we put this down to the devotion of the staff at Shaen, despite the fact that they were working under the shadow of closure and lack of job security.

In January 2008 shortly after Maureen was admitted to Shaen, the residents, staff, families and others collaborated on a vision statement which began with “We believe the purpose of our care centre is to develop person-centred care in a homely environment where there is respect and dignity for the resident, their families, friends and staff.”

This was a working document with an ethos that put residents at the very core of Shaen’s care system and has not to this date waivered from its ethos.

We know what it is like when a relative through ageing and ill health becomes a victim to cognitive impairment, leading to a weakening of mind and body and eventually death.

Visiting a relative in Shaen has never been a chore but something to look forward to with attractive grounds nested in the beautiful Laois countryside reflecting the coming and passing seasons to its residents.

From the moment, visitors enter through the door, we are greeted with a warm welcome, an update on how our relative is and an offer of a cuppa of some sorts.

We can see with our own eyes the dedication and committment the staff put into the delivery of this care plan, for each resident’s individual and bespoke needs - nothing seems ever too much and staff undertake their work with dedication and geniality.

A solidarity has also evolved amongst the visiting families and friends, we greet each other kindly, we ask after each other and we come together and celebrate at the numerous activites organised for the residents such as the summer and christmas parties, sing-songs, drama productions, masses.

In recent years Shaen has been plagued by rumours of impending closure with the HSE in 2011 proposing that the Hospital would be closed on a phased basis, and its 28 long-term residents and three respite clients being relocated to other facilities.

The rationale for the closure according to the HSE has been due to financial reasons, the pubic sector staff moratorium and compliance with future HIQA standards.

The lead up to this decision and the current impasse that residents, their families and the Shaen Action Committee now find themselves in has caused undue stress to residents, families and hospital staff.

The closure is interpreted more keenly as a criticism of the physical layout of the unit and the significant financial investment required to accord with the standard of a contemporary purpose built care unit.

There is no doubting that a first world country such as Ireland should have purpose built physical infrastructures that provide ‘homes’ for our elderly and particularly our elderly with cognitive disorders including dementia.

However, it does not make sense for many of our elderly and infirmed to be abandoned to the current healthcare crisis where hospital patients are left on trolleys.

The care of our elderly is at a crisis point and the lack of regard for their care is highly questionable.

Cllr Willie Aird has only recently commented that “(Shaen and Abbeyleix) hospitals have given countless services to people across Laois over the years. They’re available, the wards are there, the facilities should be utilised to allieviate the crisis”.

As recently as the 21st January 2015, the Minister for Older People stated “we cannot afford to lose” public nursing homes including St Brigid’s Hospital, Shaen and Abbeyleix Community Nursing Home.

Labour’s Kathleen Lynch had been responding to Dail questions from Fianna Fail Laois Offaly TD Sean Fleming who claims an extra 70 beds could be provided across both facilities with investment of a couple of million euro.

As family members, we are well aware that our elderly are being sacrificed currently. We are constantly reminded that someday we too may find ourselves at the mercy of the HSE and what could be considered their current hapless strategic planning.

There is also a genuine fear that the exceptional standard of care found in facilities such as Shaen may not be replicated.

In 2012, HIQA found that the health needs of Shaen’s residents were met and the quality of care and experience of the residents were monitored and developed on an ongoing basis.

However, they observed that the privacy of residents was not being met with shared bedrooms and bathroom facilities and the recommendation would be to have single rooms with attached bathroom facilities.

This observation may be valid but we have also observed the benefits of companionship that exists with residents sharing rooms. Single rooms may bring about privacy but does it not also cause remoteness, desolation and loneliness?

The commendations and positive affirmations from HIQA’s report do not sound as if they should be about a hospital that is under threat of closure and are in stark contrast to the HIQA Chief Inspector Phelim Quinn’s comments in 2014 that they had received 5,362 reports from different sources including relatives and staff about nursing homes in Ireland.

These involved serious accidents including injury; unexplained absences by residents; lack of suitable staff training in fire prevention; amiss in the area of ordering, prescribing, storing and administering medicines to residents – as well as the handling and disposal of unused or out-of-date drugs; and compliance with regulations regarding resident’s safety.

According to the HSE website, ‘only about 5% of all’ older people (will) ever need residential or nursing home care’. It is apparent that due to the lack of financial investment in existing nursing homes and the planning and delivery required to grow these facilities according to and in line with national and international standards, Laois and other counties may not now have the most ideal capital infrastructures for 21st century professionalism and resident care.

The HSE may now insist in economies of scale and centralisation of care, however, at all times the actual care for the 21st century resident should be of a generic high standard throughout Ireland, both rural and urban.

This care should be of a standard that inherent in its delivery considers the uniqueness of the resident, their care needs and also their personalities.

A one brush stoke approach cannot be sufficient. The same applies to the expertise of the management and staff of hospitals, such as Shaen, where years of dedication and professionalism have been invested and attuned to the medical, palliative and spiritual care of their residents.