Palliative Care Fund celebrates 30 years

Thirty years on and Jimmy O’Donnell still remembers vividly the set of circumstances that ultimately led to the foundation of the Cavan Monaghan Palliative Care Fund and is wowed by the legacy he and his late father and others have helped create.

In 1993, John Joe O’Donnell was nearing the end of his life. Bone cancer had cruelly begun to chip away the very essence of who he was, replacing it with only a deadening pain and discomfort.

John Joe first fell ill in 1991 but, by early 1993, the illness really began to take its toll.

“It spread from prostate to bone. We struggled to mind him at home, but that’s where he wanted to be,” remembers Jimmy.

A native of Kilconny, Belturbet, John Joe was under the care of Dr Niall Hever. At the time, and after one “particularly bad night, of which there were many”, Dr Hever recommended that Jimmy seek the help of Cavan General nurse Moya Carroll.

Working in paediatrics, Moya was one of only a few in the country, and certainly this region, with training and experience in end of life care.

She passed through Belturbet from her adopted home of the Ballyconnell twice daily, and following Jimmy’s approach, she readily agreed to bring with her a morphine pump and attend to John Joe.

“Rigged up”, the result was instantaneous.

“Like most people, he wanted to be in his own corner,” said Jimmy of his fast ailing dad. “From when Moya connected up the meds, she’d come in the mornings and again in the evenings on her way home, we got three or four days with dad we’d never have had. He was totally comfortable, totally pain free” and it meant the O’Donnell children were for the first time in months able to “reconnect” with their father beyond the confines of his sickness.

“Every time this lady came through the door, it was like someone lifted a weight off our shoulders,” said Jimmy looking towards Moya when speaking to the Celt when he and the Cavan-Monaghan Palliative Care team recently gathered to celebrate the fund’s 30 years at the Dochas Centre, St Patrick’s College.

Back in those days Moya says that palliative care “wasn’t new”, but it wasn’t readily available in all parts of the country.

“It was a new word for a lot of people. It was perhaps better known as hospice care, which is the same thing essentially, except palliative care became more associated with community, and home,” explains Moya, who says she always had an interest in care for the dying.

Mary Lennon was the palliative care nurse for Monaghan, and Maura McDonald, then Director of Nursing at Cavan General, had previously spent time working in Harolds’ Cross. It was from her experience there that she harboured an ambition to see the discipline extended across rural Ireland.

“Monaghan started before Cavan, and when Mary went on leave, I did her relief,” recalls Moya.

When Jimmy first contacted Moya, she could see that he was “someone in need”.

“I remember going up the stairs and meeting his dad in the bed, the family were all there. In a way people look and they have expectations, but you do what you can. I had the course done, I was the only person in Cavan, but I could see where there was this need, and how palliative care could be developed into the future.”

Before John Joe died, he told Jimmy coming out of St Luke’s in Dublin it was his wish to one day do something for the nurses who had cared for him so diligently. He never got round to achieving that personally but his son took this final request to heart and began fundraising for the purchase of equipment for the newly-formed Palliative Care Team in Cavan.

“Dad was always very appreciative of even the littlest thing done for him, but the disease took over. We kept in touch with Moya because we were so blown away as a family with those few days we had with dad at the end.”

Jimmy’s now late brother Joe helped organise a Weekend Golf Classic at Belturbet Golf Club, the proceeds of which were used to buy four new morphine pumps. What was left in the bank account, just £300, Joe said to Jimmy to “keep it there and give it a name. In time this thing will take on a life of its own.”

When in 1999 the Palliative Care Team’s remit was expanded to Monaghan, the small pot became what is today known as the Cavan Monaghan Palliative Care Fund, raising “millions” in the care and support of countless families across the two counties.

Today, there is now a HSE team of up to 20 people working in palliative care and other specialisations in Cavan and Monaghan, led in their respective roles by guidance of Dr Wilhelm Freiherr Von Hornstein, Consultant in Palliative Medicine.

Looking back Jimmy describes the support the fund has received and continues to receive from the people in Cavan and Monaghan as “heroic”.

All funds raised are placed at the HSE-run Cavan Monaghan Palliative Care team’s disposal, to be used “as they see fit” in the care and comfort of those dealing with end of life diagnosis. This includes everything from paying for taxi services, financial assistance in cases of hardship, provision of night nursing, automatic stair lifts, home help, and other requirements.

Apart from annual fundraising events, a considerable amount of money received comes directly through the efforts of relatives and friends of people who sadly passed away through illness.

Year on year the fund needs to find at least €150,000 to keep its books in the black. It use to be €50,000 and then €100,000. “We might have raised millions but the thing is we spend our money,” says Jimmy who, when he walked into the Dochas Centre on the morning he met with the Celt, signed a cheque for €11,500 for new equipment.

“I was reared on the clippings of tin, and I’ve always believed in keeping a little bit back for a rainy day. It means that, in those 30 years, no palliative care nurse has ever been found wanting, and we want to keep it that way.”

The Cavan Monaghan Palliative Team and the fund was there to support Claire Connolly’s father Philip as he edged towards his end of life following terminal diagnosis in October 2022.

Philip sadly passed away in June 2023 but, before that happened, his daughter reflects on how the Cavan-Monaghan Palliative Care team acted as the family’s “guardian angels”.

“From the moment they walked through the door, we immediately felt that here was someone to help. I don’t know what I would have done without them. They were so practical, and my father was so private, he never wanted anyone else in the house or anything but, whatever they did, they were able to find a way to get through to him. It got to a stage where you’d be nearly looking forward to their visits.”

Philip, who lived his life an active man, died aged 86 years. His illness began with a melanoma, but the cancer then spread to his lungs and several other parts of his body including the bowel and liver.

He was given just eight weeks to live at that stage. But like Jimmy in the care of his father, Claire strongly believes that palliative care gave the family additional time with Philip they otherwise might not have had.

“The last few weeks were the most difficult. But, even then, towards the end, you just knew and you felt, more importantly, that you were in good hands.”

Moya is retired now but she and Jimmy reminisce over the challenges the service has managed to overcome down through the years. “Distance was a big one, because Cavan is a big county, a long county. It’s a long journey from Kingscourt to Swanlinbar. The other biggest thing was just how bad the roads were. They were appalling in places. It is amazing the difference now. I knew every road in Cavan at a time, by-roads and side roads.”

They praise too the role of GPs who, like her, could see the value in palliative care - “giving someone the opportunity and comfort to die in their own home. Not alone, that’s the main thing.”

“Trust,” she adds, was and is a major element in the success of the palliative care system. “A lot of it was to do with building up relationships, with doctors and public health nurses. If you have them on your side, you can move mountains. As time passed then it became more about managing numbers. They’re nothing like they are now.”

Since Covid Jimmy puts patient numbers, post Covid, as rising from an average of around 350 deaths a year to 500 as of now.

He says the “everyday stuff” people often take for granted, once mounted up, can become “insurmountable” for some families with a loved one facing end of life. That’s where the Fund steps in. “You cannot anticipate the challenges faced by a family until you’re actually faced with a situation yourself.”

Jimmy lives each day “wowed” by the legacy of the Fund he helped create.

“What I’ve gotten from it personally is I have met some of the most extraordinary individuals, not just the team, but the communities. To them I need to say thank you. What this has always been about is people.”