‘Palliative care can prolong a life and it can enhance the quality of that life’

John Bowens had good reason to love his house, his home.   The Bowens family have lived there since the late 18th century. John himself was born there in 1931. He and his wife Mary had just shy of fifty years of married life there.  He had been born there, he had lived there, and it was his wish that he would die there.

   Sitting across from me in the Abbey Hotel are Mary Bowens and her daughter, Marie Gillooly. Outside, it’s very cold, but pleasant. Christmas is beginning to take us all into its embrace, and ‘the Abbey’ is warm and festive. We order coffee and scones and begin our chat.

  The purpose of the interview is to highlight the scale and quality of the local palliative care service. Hundreds of families have reason to avail of it in hospitals, and some people avail of it in the home. Perhaps not enough families realise just how beneficial the service ‘in the home’ can be. Perhaps not enough families know enough about palliative care, about the great marriage of medical care and emotional support that it is.

  Like thousands of families throughout Ireland, the Bowens family in Strokestown reached a point in their lives where palliative care suddenly had a presence. They were greatly impressed and hugely comforted by their experience of the service. Now the family wants to “give something back” to the Mayo/Roscommon Hospice. They want to spread awareness about the service, highlight what’s available, see if others can be helped by reading the story of their very personal experience.

Everyone in Strokestown, and many people elsewhere, knew John J. Bowens. He was born in Curskeagh, just outside the town. They knew him in football circles and they knew him in farming circles. They knew him through his love of music (he was a member of the Choir in both Strokestown and Kiltrustan Churches). They knew him as a neighbour and friend. In his youth, he was a keen footballer, and throughout his life he had a great interest in amateur drama and music. Some knew him through his passion for hunting and shooting (“he shot for the kitchen table!” says Mary). Sociable and outgoing, he enjoyed a pint and a bit of craic, usually in Pat McHugh’s or Leo Caslin’s.

  John married Mary (nee McNamara, from The Walk, Roscommon). They had four children: Patrick, Marie, Aileen and Sinead.

  John Bowens was a big, strong man, a hard worker who was still close to being in his prime when the first signs of illness emerged. It was 1995 when he was diagnosed with prostate cancer. Treatment in the Mater Private Hospital in Dublin followed. John’s quality of life was good, but when he developed secondary cancer eight years after the initial diagnosis, it was the beginning of a long journey for John and his family.

  In 2003 it emerged that John had two tumours in the spine. He also had bone cancer. Now he began to receive treatment in hospitals in Sligo and Galway. John’s family were always there for him. Mary and the couple’s four children all formed a support structure.

  In 2012, there was another setback, when John suffered a stroke. It was a bitterly cold, frosty morning. His son, Patrick, living next door, looked across at his parents’ house and saw his dad slumped in the yard.

  “We brought him to Roscommon Hospital and they saved his life there” Mary Bowens recalls. 

  John’s morale remained very good, but his health had now taken a very serious turn and he was fighting illness on a number of fronts…the cancer having spread and the stroke impacting on his speech, his mobility and general quality of life.

  Through great persistence and the support of his family and doctors, he recovered his speech and mobility.

  Around this time, an offer of palliative care in the home was available, but the family refused it.

  Mary Bowens says: “We refused palliative care at that time. That was a mistake. I think people fear that if they accept palliative care, it means the end is coming. But we were wrong to refuse it.”

  Her daughter, Marie, agrees.

  “Palliative care, we have discovered, is not necessarily the end of a life…it can be the prolonging of a life and it can enhance the quality of that life.”

  Instead of opting for palliative care, the family continued to care for John in his own house, a routine that was interspersed with increased hospital stays.

  Then one day in late 2012 John began to haemorrhage and was rushed to Sligo Hospital, where, in a hectic A&E Department, he had to spend a harrowing nine hours waiting to be tended to.

  Around this time, and in consultation with John’s medical team, the family agreed to accept palliative care in the home. In practise, this meant weekly visits to the Bowens’ home by a palliative care nurse. Any time there were any new concerns about John’s health, the palliative care team was available, on call ‘24/7.’

  “John looked forward to the weekly visit by the nurse,” says Mary. “They were marvellous. They did so much for us. They gave John so much peace of mind.”

  Mary and Marie explain how much the presence of the palliative care service in their home helped relax John. There was the actual medical care, the emotional support, and invaluable practical advice too. For example, when the time was right, the nurse was able to advise on John settling his affairs. It meant more peace of mind.

  As Mary points out, many people in these situations haven’t made wills.

  “People feel if they make a will that they’re going to die the following week” says Mary, a sentiment that people will identify with.

  The family’s experience was that the palliative nurses caring for John were very much working in tandem with his GP, and with the hospital-based experts. Knowledge was being shared. 

  Marie says of the service: “It became a constant balancing act. The nurse religiously called to our house every week; then if we saw a change in him we’d ring in to palliative care and an ambulance would usually arrive within twenty minutes. And when dad got to hospital, he was seen quickly, because there was so much communication…the palliative team were marvellous. They were able to prepare us for what was coming and were improving dad’s quality of life all the time.”

  By early 2014, John’s condition had weakened further, and the family were called in to speak to his doctors. Although the end was near, he rallied with remarkable resilience. He spent periods in Roscommon Hospital, before summoning the strength to return home again. The family describe the palliative care service in Roscommon Hospital as “excellent.”

  Friends and neighbours visited John in the hospital and his family smile now at the memory of laughter and jokes, and even the odd song, coming from his bedside.

  He had a bad turn in June of 2014 and was admitted to the Galway Clinic. After a few weeks there, he returned to Roscommon Hospital in July.

  But still he wanted to come home. To his own house.

  The palliative care people got to work. The Bowens’ house was adapted as required; a special bed and a hoist were put in. On a Monday in July, John came back to Strokestown. He was at home now with his wife, and with his children close by. He delighted in the company of his grandchildren. He was able to enjoy his own garden, relax in the most familiar of environments, reminisce with family and friends. The family have no doubt that his being at home meant everything to him. They were two very special months. 

  When the end was near, a palliative care nurse attended nightly, arriving at 11 o’clock and staying until 8 am. It meant that Mary and other family members could get some sleep.

  “That nurse was an angel on wings” says Marie.

  On Thursday, September 25, 2014, family members were gathered at John’s bed, praying with him, telling stories. A palliative care nurse whom they hadn’t met before knocked at the door. At first it almost felt intrusive, but when the lady came in “she was unbelievable.”

  It was another insight into the service. This nurse organised everything, but still knew precisely when to give the family their personal space. “She was a great support” they say. She “took over”, but in a non-invasive way.

  They were amazed at how many things family members don’t think of in these end-of-life moments.

  They saw how these matters are attended to in a professional and sensitive manner by the Hospice service.

  John passed away at 10 o’clock that night, in a room filled with love.

  Mary, his wife of 49 years, drew great comfort from the care her husband received. Her advice now is that people should get palliative care “in early” as it brings comfort to the patient and their family, prepares people, and provides peace of mind.

  “Dad had a great outlook on life and a great outlook on death” says Marie. “He told us that everything was much easier for him once he was able to be at home. And the Hospice staff did everything they could to help make him as comfortable as possible in the home. In the end, he was able to die with dignity at home.”

  Mary adds: “It was his wish to go home and to die at home and only for the support of the palliative care team it wouldn’t have happened. We are so grateful.”

  It is one story of one family’s experience. There are many such stories out there in our towns and our villages. There will be more such stories. It is important that families appreciate the service, based on care and dignity, that is available through Mayo/Roscommon Hospice. 

Fifteen months have passed since John’s death. His family are grieving, but they know everything possible was done for their loved one, and they have the happiest of memories.

  For his 80th birthday, his family arranged for John to record with Jimmy Hussey. Two CDs were produced, with John singing classics such as ‘Old Man River.’ Another favourite was ‘Star of the County Down.’

  For many years, when there were funerals in the Church, the local priests would call on John to sing ‘Going Home.’ Now, at John’s own funeral, the Solstice Choir and the choirs from Strokestown and Kiltrustan all came together, and they sang ‘Going Home’ for John.

  Going home had always meant everything to him.