Emir Murphy

My name is Emir Murphy and I am a clinical specialist, speech and language therapist. And I work in the Kerry Specialist Palliative Care Service. We have an in-patient unit and an out-patient unit. Our in-patient unit is 15 beds. It was only built very recently in 2018 and then we have an out-patient service and we also have a home care service.

I think the reason why speech and language therapists are mainly involved in palliative care is that palliative care is not just for people who only have a few weeks to live. We work with people who have severe, progressive disorders. For some it might be a very mild speech problem, and for others it may be total loss of speech where we need to help them to have a communication aid so that they can talk to their family. We also then work with patients who have swallowing disorders so a lot of patients towards the end of life will have conditions which will cause damage to the swallow.

The first time I met Tony he was very, very sick. He came into our day patient service and he couldn’t swallow anything so literally I had a patient in front of me who was coughing and spluttering and getting very distressed because of the coughing situation so he already was very debilitated and unwell. He has an underlying chest condition which means that any bit of food or fluid going into the lungs was going to make him very sick. At that point we didn’t know if Tony was in the very end stages of his life or not, until we did all the tests and until we actually saw him for a couple of days. So after a few days of stablising Tony in the hospital with the rest of the team, I then proceeded to do an x-ray of his swallow we call that a video fluoroscopy. So once we had the x-ray of the swallow that was able to show us that a lot of Tony’s difficulty was related to a muscle weakness. So then we were able to put in place a plan for him of rehabilitation of those muscles but bearing in mind that Tony was also still very weak. So there was a lot of discussion with Tony about how difficult that would be because again it takes energy to do exercises for swallowing and he was agreeable to that. I was able to say OK, from now on I’m going to be your coach, I’m going to be there to help you with this, advise you on what exercises will help your swallow and at the same time you need to be able to judge how far can I push this very sick man. But gradually he has climbed that mountain and now he is able to have his spuds and salmon, his pint of Guinness. but he is very happy with where he has gotten to now. I think people need to know first of all that palliative care is not just about dying. That it’s about living well and it’s about knowing that there’s a team that can help you psychologically. Like in Tony’s case it’s not just Tony we helped, it was also supporting his wife. A palliative care team looks at the bigger picture. What more can I say about palliative care – going the extra mile, yeah, I think they do.