‘Hospice is about living, not dying’ – Malta’s big misconception challenged

Hospice Malta focuses on quality of life, not just end-of-life care, with an emphasis on living well despite illness, chairperson Bernadette Bonnici Kind said.

Hospice Malta prioritises helping patients remain at home for as long as possible, Bonnici Kind said in an interview with The Malta Independent on Sunday, through the various services delivered. Support is delivered on multiple levels, including physical, psychological, social, and spiritual. This further includes the free loan of medical equipment. Care also extends beyond patients to include family members. These community-based services have been central for around 37 years.

“The biggest misconception is that hospice deals with death, but until that moment arrives, we are all living,” said Bonnici Kind. “Hospice’s mission is to make sure that while we are living, we are living the best life we can, regardless of our medical diagnosis.”

The relatively new premises of St Michael Hospice has allowed for the expansion of the organisation’s services. These include more specialised therapy spaces, increased patient capacity, and improved efficiency compared to the previous much smaller premises. The design of the building is informed by international best practices.

Hospice teams build close, ongoing relationships with patients and families, Bonnici Kind said. This continuity provides reassurance and trust. She explained that hospice care addresses the wider life impacts of illness. Serious illness affects finances, identity, and family dynamics. Hospice helps patients and families adapt to life changes, not just manage symptoms.

Bonnici Kind explained how hospice care can create meaningful, even beautiful final moments. She recounted a story of a musical family who had a member in palliative care. In those final weeks, they were reconciled to what was going to happen.

“They said they found peace and harmony during this difficult time… they spent those last weeks sharing their love of music together and grew closer as a family,” she said.

Bonnici Kind explained that there is growing awareness and demand for palliative care in Malta. There is increased public discussion around illness compared to 20-30 years ago. Moreover, ongoing awareness campaigns have improved visibility and uptake of services. According to Bonnici Kind, patients’ initial hesitation often turns into strong appreciation.

End-of-life care is still a difficult and often avoided topic. This reluctance is not uniquely Maltese, but rather human and universal, according to Bonnici Kind. Conversations often only happen when illness becomes personally unavoidable.

 

Hospice’s financial sustainability

Financial sustainability is a major challenge that Hospice Malta has to deal with. Services for patients remain completely free of charge, increasing funding pressure. This is especially the case due to the expansion into larger facilities and the new 24/7 In-Patient Unit (IPU) due to open in the coming weeks. Transitioning into a round-the-clock service model marks a major shift.

Hospice Malta relies on funding agreements with the government’s Health and Family ministries, donations, legacies and fundraising activities. Despite this support, long-term sustainability remains crucial, especially with rising costs.

“Our biggest concern is being unable to assist patients in the future,” Bonnici Kind said.

Although the new building itself was donated by the Archdiocese of Malta, conversion costs were substantial and different funding programmes were utilised to cover the premises cost of around €13 million to renovate and adapt. That being said, Bonnici Kind framed it as a national healthcare investment, particularly given cancer’s widespread impact. She emphasised that small donations at scale can make a big difference, and encouraged both financial and non-financial contributions, such as time and volunteering.

“It doesn’t have to be money – you can give time. And the satisfaction you get is something you can’t buy,” Bonnici Kind said.

The NGO has a large volunteer base and organisational structure. Hospice Malta has around 200 volunteers, providing around 13,000 hours of volunteering work every year. Its Board of Governors and committees (who are also volunteers) ensure good governance and strategic development. After moving to the new premises, staff increased from 30 to around 80, growing further to around 100 staff members once the IPU opens it doors. Bonnici Kind stressed that the success of the organisation is due to collaborative effort.

Hospice Malta recognises that state resources are finite. Bonnici Kind said that NGOs are essential gap-fillers in the healthcare system. Hospice care is a shared societal effort, she said. She thus expressed gratitude while acknowledging funding limits.

“Although the need is on the increase, the three-year funding contracts provide consistency,” she said.

Bonnici Kind acknowledged a clear shortage of specialists in recent years. That being said, the situation is expected to improve with a new qualified specialist joining the team, and additional doctors who are being trained in the UK expected to return within one to two years.

Last year, Hospice Malta received a record of over 900 new cases. This increase is partly due to improved awareness of Hospice services, apart from an increase in the mentioned conditions. Earlier diagnosis improves survival rates but also increases the need for care services. Bonnici Kind made it clear that people should not be ignoring screening invitations, as they are life-saving.

Hospice Malta believes the country compares favourably on the global stage. Ongoing collaboration with international hospices ensures knowledge exchange and continuous improvement. Hospice actively monitors international standards to keep abreast of the latest research in palliative care. That being said, Malta is not just learning – it is also contributing expertise abroad. Bonnici Kind describes Malta as “lucky” to have established services early, in comparison to some countries that have very limited palliative care infrastructure.

When the services are required, patients and families must actively apply for them. However, when referrals come very late, Bonnici Kind said, this limits the impact and full benefit of hospice services. Hospice teams can respond quickly, but holistic care, such as therapy and counselling, takes time to implement.

When asked what the top priority for Hospice Malta is for the next five to 10 years, Bonnici Kind said it is financial sustainability and expansion. The organisation continues to work at its fundraising activities to achieve this, while also aiming to increase awareness and patient reach and to expand workforce. The main focus is on ensuring Hospice Malta remains operational for decades to come for the benefit of all the local community.

For further information and support, the general public is encouraged to visit the hospice website www.hospicemalta.org as well as Hospice Malta’s social media platforms

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