35 – Care of severely ill and dying individuals

Severely ill and dying individuals need support and guidance, so that they can live out their lives according to their own wishes for as long as possible. The palliative care aims at reducing ailments and maintaining the quality of life for as long as possible.  The medical, nursing, psychosocial and spiritual care and support contribute to this with the support of voluntary outpatient hospice services.

Specific requests with respect to certain medical treatments or medical interventions should be recorded in a living will.

Detailed information can be found in information sheet no. 24.

Zentrale Anlaufstelle Hospiz (Central contact office) (ZAH) Herrmannstraße 256-258, 12049  Berlin, Telephone 030 / 40 71 11 13

(www.hospiz-aktuell.de) advises on the subjects dying, death and grief as well as living wills and provides support services for seriously ill and dying individuals and their caregivers..

Outpatient care

In general, the practitioner and the current nursing care service care for the patient in their final phase of life. If necessary, a pain therapist or palliative physician can be consulted.

Outpatient hospice services complement medical care and services provided by trained hospice volunteer helpers, who give the seriously ill or dying individual and their relatives above all time and personal attention. They also provide guidance in the time of mourning. Further information can be obtained from the “Zentrale Anlaufstelle Hospiz– (Central contact office).

If someone with an incurable, advanced stage disease with limited life expectancy symptoms, such as e.g. pronounced pain symptoms, that require a particularly complex care, a “Specialised Outpatient palliative care– (SAPV) can be prescribed by the physician. This will be provided by specially trained SAPV-doctors and SAPV-care services. If necessary, hospice services, therapists, counsellors and psychologists are consulted. The SAPV-doctors carry out regular home visits and guarantee round-the-clock availability.

Due to qualified pain management and symptom control a longer stay of the patient in thier own flat can be guaranteed.

Further information regarding SAPV from Home Care Berlin e. V., Tel. 030 / 453 43 48 or at  www.homecareberlin.de.

Inpatient care

Palliative-medical treatment in hospital

If stressful disease and treatment related symptoms can no longer be mastered at home, a palliative-medical treatment in hospital, often in palliative care stations, may bring about relief. If the condition has stabilized, the patient will be discharged home.

Inpatient hospice care

The patient can decide with the help of a medical report for inpatient hospice care. Admission takes place at a very advanced stage of the disease, in which a cure cannot be expected, and life expectancy is only a few weeks to months. A prerequisite for admission is that outpatient care at home is no longer sufficient and hospital treatment is not necessary.

Medical care in the hospice is carried out by the general practitioner or an SAPV-doctor. The hospice team ensures the palliative nursing, psychosocial and spiritual care with the help of volunteers.

Care in a nursing home

Care in a nursing home also includes care and support of the severely ill and dying residents. Various nursing homes have staff qualified in palliative care. Some work with outpatient hospice services, in which hospice helpers visit the dying residents in the

nursing home and accompany them at their wish. In addition to the primary medical care of the residents, consultation of SAPV-doctors in the nursing home is possible.