Speech by the Taoiseach, Mr. Enda Kenny T.D. Launch of “Think Ahead 2” Stephen’s Green Hibernian Club Thursday July 17 2014

Ladies and gentlemen

I’m delighted to be here today to launch Think Ahead 2.

It’s the next phase of this terrific initiative which we launched together in October 2011.

Since then many of us will have lost people we loved.

And we will have seen for ourselves how this very simple initiative Think Talk and Tell really is a matter of Life and Death.

Or rather it’s the bridge between the two.
By ‘thinking ahead’ we make our death not separate to our life but very much a lived part of it.
In a sense ‘thinking ahead’ becomes the door of our choosing the one we opt to step through.

The end of our life ‘lived’ and very much so on our own terms.
For those of us who have been privileged enough to accompany a loved one at the end of their life through their death we know what a difference the three Ts can make.

I know of a man who passed away just before Christmas.

In the hospital, he defied medicine, biology, even logic itself so he could leave the life he loved as he wished in his own home.

The respiratory consultant and his team at the hospital for their part moved heaven and earth to get him there.

Not alone was this man grateful. He was joyful.

His last days became a victory over his illness a celebration of his life his family the home they had made the life and story they lived together.

They had a laugh put Carols from Kings and Michael Buble’s Christmas on the CD tears were shed songs were sung.

In those five days the hospice home-care team were both invisible and invaluable.

Maximum help minimum awareness of intervention.

This family had done the three Ts without realising.
Consequently, they knew what their husband and father wanted. And they made sure he got it.

Now, they’re thinking and talking and telling for themselves because the sheer randomness of life means it’s never too early to start

Yes our death could come suddenly by accident, or catastrophic illness

Equally we could have days even months to contemplate how we leave our life.

In that life the only certainty we have is death.
We know it’s coming.

Which is why it’s so important to have those conversations.
To talk about our death as part of our life.

Something more substantial and significant beyond the old proposal ‘would you like to be buried with my people’.

And with Think Ahead people can have those chats, make those plans.

The findings from Dr. O’Shea’s survey – outlined earlier this morning – show that the Think Ahead approach really does work.

Crucially, it allows us to update our decisions over time.

But Think Ahead is already reaching people. In the past year alone, almost 7,000 forms have been distributed across the country. I am also very pleased to hear that work is ongoing to make it suitable for use by people with dementia or intellectual disability.

This second phase has been adapted in consultation with stakeholders, medical and legal experts, and most importantly based on feedback from users who have been at the heart of this initiative from the outset.

Also under Think Ahead 2 it will be possible for people to securely store and access their forms online. This partnership between the Irish Hospice Foundation and Patients Know Best is supported by the Third Age Support and Advocacy Service for Older People.

And of course, Think Ahead encompasses more than our own care preferences. It covers legal and financial issues, organ donation, funeral arrangements.

Above all Think Ahead is empowering. Echoing the palliative approach of the Hospice movement it puts the person who is ill at the centre of operations, making sure their end-of-life care is as close to their wish as possible.
For our part in Government, as part of the overall reform of the healthcare system, we are committed to providing a framework where people’s wishes around end of life care can be met.

i. The legislation providing for Advanced Care Directives, which many of you here today contributed to as part of the consultation process, is being advanced and will be published in the coming months.
ii. Healthcare services are being configured to provide the best care in the most appropriate place taking into account the patient’s need and choice.
It is clear from repeated studies that many people’s preference is to be treated at home or in the community insofar as is possible.

But with the best will in the world even with the most elaborate plans not everyone will get their wish to die at home.
Each year, 30,000 people die in Ireland, 43 per cent of them in acute hospitals.

We value the move by hospitals and the hospice movement to work together to give people the privacy and dignity they need as move gradually towards their Death.

This is the Hospice Friendly Hospitals programme with 40 acute hospitals already taking part.

Through the Spiral programme a spiral is exhibited at the nurses’ station signalling that a patient has begun their journey to death.

Signalling equally to staff and visitors alike that they are entering a sacred space.

Similarly, the return of the belongings of a patient who has passed away now has more formality the process more in keeping with the dignity of the person and the grief and loss of the family.

And I must say that as Taoiseach I want a situation in our health service where everyone in their last days and hours is given the privacy and dignity necessary to die as well as they can.

For now, I’m delighted to launch Think Ahead 2.

Given that death is non-negotiable, the least we should desire and gift ourselves and those we love is that we live well and die well.
With this initiative hopefully, we can.