Mr. Phelim Quinn:

One issue is the confidence of staff in nursing homes to engage in such a conversation. It requires a lot of skill on the part of staff. We see it as required depending on the medical or social history of a particular individual. When a person is admitted to a nursing home it may be for specific ill-health reasons that may indicate his or her condition is life-limiting. Early engagement with a resident and his or her family is important because advance care planning is the basis of good end-of-life care. There would be a very early conversation about the person's physical, psychological and spiritual needs so that they are addressed and people in the centre know what the person's wishes are from a very early stage. There have been debates around do-not-resuscitate orders and this is the sort of question that is explored by a resident and his or her family with the GP or any other medical practitioner involved.