The founder of the Island's only terminal care hospice - Agape House - has renewed her pleas that the facility improve the care offered to the dying and their families.

Some of the very patients the hospice was founded to help have been turned away as a number of beds have been redirected to the hospital's extended care unit (ECU), former coordinator Hilary Soares said.

And crucial helping services to the families of the dying were cut and never reinstated, she added, while nurses are critically overworked.

Last week, Dr. David Harries of the hospital's continuing care unit said the hospice continues to offer quality care to patients despite hurdles, in response to earlier criticisms.

Mrs. Soares said she agreed with some of Dr. Harries statements but feels there are still tragic failings at the facility.

"Recently a patient's family told me of their dying father and husband who asked for admission to Agape House," Mrs. Soares said. "They were told the hospice was full.

"The patient died at home, a week or so later, without the benefit of the hospice's symptom control services, with the son-in-law taking care of the patient, 24 hours per day for that week.

"Apparently (ECU) patients filled three beds so the hospice does not have the capacity to admit bona fide patients when nine of the beds are full."

Mrs. Soares said allocating hospice beds to ECU patients made Agape House merely an extension of the hospital rather than the full counselling and treatment centre it was intended to be.

"The medical staff provides one side of the care at Agape House with the other side of care properly being provided by other kinds of care givers, such as bereavement counsellors, on staff massage therapists, art/music therapists, a chaplaincy service and legal assistance," she said.

She added: "Worries, anxiety, problems all go together to make the patient as comfortable as he can be. Unless the problems are solved for him in a physical, emotional or spiritual way, the likelihood of the doctors achieving amelioration of his condition becomes uncertain.

"One can easily die of unremitting pain if it is ongoing and severe enough."

Mrs. Soares criticised the decision to allocate hospice beds to patients from the ECU even if that unit needed the beds.

"Appropriate patients referred from the community and hospital are the answer to the bed capacity at the hospice," she said.

Last week Dr. Harries said the number of beds in the hospice is already `generous' for a population of Bermuda's size.

Mrs. Soares also stressed workloads which overwhelm the nurses erode the care of hospice patients at their most crucial hour.

"They have to bathe patients as early as 6. a.m. in the morning so they can get through their daily amount of work, because they are so few in number," she said.

"A patient need not necessarily be fully bathed on any given day. It is often up to that patient to say what wishes to be done, and the hospice staff honour that, and be allowed to sleep as long as he wishes."