Why is hospice care important


Topic overview


What is a hospice?

The term hospice comes from the Latin word “hospitium” for hostel and describes a facility in which terminally ill people are accompanied and cared for in the last phase of their lives. The hospice as an institution is often relatively small inpatient facilities, the Palliative care units in hospitals as outpatient hospice services for home care. It accepts people who do not require hospitalization and who cannot be adequately cared for at home by their families or in the nursing home.
The term hospice is not only used to describe formal structures. Behind the hospice movement there is a content concept with globally uniform labels. The Hospice concept is through the so-called Palliative care, the holistic care of the dying and their families, put into practice. The aim is to make the life of the dying as comfortable as possible until the end. However, German hospices do not operate euthanasia, i.e. they do not intentionally induce death.

Hospice concept

What characterizes the idea of ​​the hospice?

The palliative medicine specialist and pioneer of the German hospice movement Johann-Christoph Student names five content characteristicsthat have in common hospice offers worldwide:

  • Focus on the needs of the dying and their relatives

  • Support from an interdisciplinary team (including doctors, nurses, pastors and social workers)

  • Voluntary hospice work for everyday tasks (cooking, shopping, etc.)

  • Pain relief to increase the quality of life instead of curative medicine to increase the quantity of life

  • All-round care with bereavement support for the bereaved

  • In a hospice, the dying decide how they want to shape their last phase of life. The focus of the care is not only on the sick person, but also on their relatives who are also suffering. Those affected are looked after by one interdisciplinary teamwhich, thanks to its knowledge and skills in medicine, pastoral care and social work, is able to cater to all of the needs of terminal care. The hospice care also lives off volunteer work. Volunteers shop, cook and talk to the residents of a hospice. They bring a piece of everyday life into the life of the dying. Another important aspect of hospice work is that Palliative medicine. In a hospice it is not about healing, but about pain relief and thus about the Improve quality of life. The fifth characteristic of hospice work for the palliative medicine specialist Johann-Christoph Student is the constant availability and thus the comprehensive support of the patient through the hospice service. The care of relatives after the occurrence of the death in terms of mourning work is part of the holistic hospice work.

Palliative care

What is palliative medicine?

The hospice concept is strongly interwoven with palliative care (lat. “Pallium” for “coat”, English “care” for care). Palliative care is an independent term that is usually not translated in specialist circles. The terms palliative medicine, palliative care, palliative care and palliative work are also used in this context. This treatment concept is about holistic care of seriously ill people and their families. Depending on the needs of the dying person, palliative care includes one medical, psychological and social care as emotional and spiritual support. In contrast to curative medicine, palliative medicine practiced in hospices is not about curing an illness and extending life, but about alleviating symptoms, especially pain. Many terminally ill people receive life-extending treatments, which are often combined with lengthy hospital stays and debilitating therapies. However, some people do not want a short-term extension of their lives through such treatments, but rather a chance to use the remaining time as possible pain-free and according to your wishes to spend. Palliative work helps the dying to be as active as possible in their life.
In general, the term palliative care encompasses more than hospice care. Palliative medicine often starts at the beginning of the disease and can also be used in parallel with curative medicine.


How are hospice services financed?

The Health insurance (and depending on a care level, the long-term care insurance fund) subsidizes inpatient or semi-inpatient hospice care 95 percent. The share of health insurance was increased from 90 percent to 95 percent in December 2015 as part of the Hospice and Palliative Care Act (HPG) and is anchored in the Social Security Code (SGB). The hospice or the provider usually takes care of the five percent co-payment Donations a.
The outpatient hospice service is provided by professionally trained volunteers and is also supported by the health insurance company. For those affected, the hospice offers have been general since August 2009 free of charge.


How have hospices developed?

The history of the hospice as an explicit place of care for the dying goes back to the first half of the 19th century. In 1842, a facility dedicated to caring for the dying was founded in Lyon for the first time. The modern hospice and palliative movement can be dated back to the 1960s. The English doctor, nurse and social worker founded in 1967 Cicely Saunders St. Christopher’s Hospice in London. For the first time, pain therapy, an important pillar of the modern hospice concept, was focused on caring for the dying. It was also Saunders who developed the outpatient hospice service a few years after the opening of St. Christopher’s Hospice, as she noticed in her work that many people would rather spend the last phase of their life in their own home. The Zurich-born death researcher contributed to the worldwide spread of the hospice idea Elisabeth Kübler-Ross significantly contributing to.
The first palliative care unit in a German hospital was opened in 1983 at the University Hospital in Cologne. The first inpatient hospice in Germany was created in Aachen in 1986. Other hospices followed, as well as numerous citizens' initiatives and voluntary associations that played a key role in spreading care for the dying.
In Germany there is, according to the German Hospice and Palliative Association 214 inpatient adult hospices and 14 stationary hospices for children and adolescents, around 1,500 outpatient hospice services and more than 250 Palliative care units in hospitals (as of 2014).

Children's hospice

What are the characteristics of a children's hospice?

The care of terminally ill children, adolescents, young adults and their families takes place in children's hospices. In Great Britain in 1978 the first children's hospice. The first German children's hospice, the Balthasar children's and youth hospice, was opened in Olpe in 1998.

  • The Balthasar children's and youth hospice
  • The farewell area of ​​the Balthasar children's and youth hospice
  • Wind turbines in the garden of the hospice as a souvenir of the deceased children

Child hospice care is about one comprehensive treatment of all those affected on a psychological, physical and social level. According to the definition of the World Health Organization (WHO), palliative care for children is already beginning after establishing the diagnosis. The family is looked after even after the child's death. Palliative care for seriously ill children begins regardless of whether the children are receiving therapy that is directed against the disease. The care in children's hospices takes some of the burden off the parents. So the parents have a little one free space for yourself and other family members. The time together with the child can also be organized differently if palliative care is ensured.

Other sources

Author: Anja Rohde - Image sources: Header image © C. Sollmann / Bestattungen.de, children's hospice image gallery © Balthasar children's and youth hospice / photographer Kathrin Menke

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