Of death – for many an uncomfortable subject. Senior physician Philipp von Trott knows from his everyday life on a palliative care station, not only medical qualities are in demand: “several Times I have experienced that a wife says to me: ‘I know I’m going to die. But you don’t tell it to just my husband.'” The husband had then said: ‘I know, you will die, but don’t ever tell my wife – she knows nothing about it.'”
Palliative physician, of rut, of working at the community hospital havelhöhe, Berlin, arranged then an open conversation with the two. The relief after the exchange is mostly indescribable.
“For as long as possible, with the best possible quality of life”
Palliative wards in hospitals are often misunderstood. There may be people with a curable disease although. This does not mean, however, that death is imminent. “Our Job is to ensure that patients have for as long as possible, the best possible quality of life,” explained Trott.
The patients who are mainly suffering from cancer spend, on average, nine days on the Station. There will be considered: Is a further chemotherapy make sense? How do you keep the pain small? What the Affected person wants for the future? What must organizationally be clarified?
To these concerns, an interdisciplinary Team of Physicians, therapists, nurses, social workers and voluntary care. It is not primary to the disease, but Healthy in the people, the resources. The are mobilized to the maximum, it goes back home. Not uncommon for years – if the Patient arrives early enough. But there lies the Problem.
“Palliative care unit many connect with Terminus,” says Trott, “if I go there again, I will leave the never again.” The result is that patients seek help far too late to palliative stations or specialized Doctors. And this in turn has the consequence that, in fact, more people die in the hospital, as it should be. Because most people want to die at home. In reality, the last Station, however, is mostly home, hospital, or hospice.
Cared for at home
The palliative care is often also very good at home. Mobile Teams come to the bedside to help in case of complaints, to treat aches and family care. “Our Job is to serve the members,” says Alexandra Scherg from the University hospital Düsseldorf. To say “to them that you can still go out once in a while. You need to pay attention to yourself.” The Doctor teaches in Düsseldorf medical students in palliative medicine.
Who does not need close medical supervision but, nevertheless, a specialized care, can also be in the hospice well cared for. “Hospices take on patients who have a limited life expectancy of a few months,” explains Scherg. There you are not alone, there is always someone there. In addition, the facilities, members of relieve.
“If a child is in the household of the seriously ill, many to the question of whether it is reasonable to die at home”, so Scherg. Then a hospice can be a very good solution. This may also be the case if the state of health deteriorated rapidly and at home it is bad to be dealt with. Or if there are no members more.
How to be used the last time?
“Dying is a process,” describes of a rut. Also with a lot of experience and the Presence of the diagnosis, it is difficult to give a concrete forecast for the life expectancy to make. Nevertheless, it is important to answer the questions of patients and relatives as openly as possible and be honest and stand up for conversations on existential topics. How to be used the last time?
Sometimes last wish play a big role. “We have already brought the horses in the clinic’s Park”, told Sharq. Not infrequently the Dying really wait on it to experience a certain thing, to find their final resting place.
If the desire can not come to the hospital, also comes times of the wishes of car: Specially equipped vans and Volunteers of the Arbeiter-Samariter-Bund (ASB) to bring the Sick to the place where you want to make sure whether to the sea or to a concert. Relatives can also be implemented in the requests, the wishes purely through donations. The resonance is huge.
The last breaths
Eventually he came but, in the last day: If the Dying power of the last breath, it goes in the palliative care to the Dying and their families alike. “Not every death is beautiful, I must say quite clearly,” says Scherg.
Medically it is made as easy as possible. Of heartbeat and breathing is often seen that the Dying spiritual counselling perceives. Just sitting and calm, the works. Just as important, however, is that members push themselves.
Dealing with grief is different. Of rut has experienced from silent grief up to a loud, collective shout, in the family circle Different. It was all human, he says. It is important that time for a farewell stay and the deceased a last honor proved.
In the anthroposophically guided Havelhöhe this means, for example the Rubbing of the body with rose oil, to the ordinary beds of the deceased and the Open window.