What is palliative care
Palliative care: support in the last phase of life
Three out of four Germans wish not to die in hospital. Palliative care is a specially designed care model for terminally ill people and offers an alternative to hospitals and nursing homes. Palliative care is intended to increase the quality of life of people in their “last phase of life” and enable them to age with dignity. In the course of palliative care, the main aim is to alleviate the patient's symptoms.
Palliative care also includes one psychological care. This tries to take away the fears of the sick. The fear of suffering or pain in particular often represents a considerable burden for the sick. Due to the various implementation models of palliative care, those affected are able to care for theirOld age in the home environment to spend. The patients are adequately cared for at all times and accompanied in their everyday life. This holistic care service can, for example, be provided by hospice services or specially trained “SAPV teams” (specialized outpatient palliative care).
What is palliative care?
Palliative care refers to the care and support of seriously ill people or people with degenerative diseases during the last phase of their lives. In contrast to curative therapy, which aims to achieve a full recovery of the patient by combating causes and symptoms, palliative care is limited to the symptoms and To contain patient pain and, if possible, to alleviate it.
Palliative care should serve to maintain or even improve the quality of life of those affected as much as possible. Above all, life should not be prolonged at the expense of quality. However, palliative care clearly distances itself from active euthanasia measures.
It not only includes palliative medical care for those affected, but also social interaction, psychological care and spiritual counseling . The care recipients should be given the opportunity to spend their retirement years in their familiar, home environment. However, palliative care can also outpatient or inpatient be carried out by various institutions.
Seniors in retirement homes - palliative care
The relatives of those affected can also receive support and advice from these bodies in the course of palliative care. Palliative care can be carried out in different models in a hospice or clinic as well as at home.
In addition, palliative care can also be used in a day hospice. The patients receive adequate care and care for one or more days a week and can return to their own home in the evening. This day hospice is often set up and operated by regular hospices.
Models of palliative care at home
If the state of health of the care recipient allows it, he can receive palliative care in a home environment in various ways. By a adequate all-round care and symptom control of patients, hospitalization can be avoided. In addition to outpatient palliative care services, there are more than 500 inpatient facilities in Germany that specialize in palliative care (as of December 2016).
Palliative care teams
The palliative care teams are officially referred to as “providers of specialized outpatient palliative care”. The palliative team always includes trained people Palliative physicians and nurses who carry out their work full-time. Ideally, these will be supported by some volunteer carers. Pastors, social workers or psychologists can also belong to the palliative care team. The teams can work in outpatient palliative care at the patient's home as well as in an inpatient setting in hospitals. To avoid hospitalization, the outpatient teams must be available and ready for the care recipient at all times.
Specialized outpatient palliative care
Since 2007, everyone who suffers from a progressive, incurable disease that requires particularly extensive care has the right to specialized outpatient palliative care (Section 37b of the Social Code, Book Five). Specialized outpatient palliative care (SAPV) includes medical and nursing services as well as one 24-hour standby, as well as a psychological and social care. To ensure this, the SAPV is provided in cooperation with, for example, pastoral care institutions, social workers or outpatient care teams.
Outpatient care services with specialized palliative nurses
The number of outpatient nursing services in Germany that employ certified nurses with additional training as palliative nurses is steadily increasing. These care services take on tasks like that Monitoring the appropriate therapies of the care recipient and other palliative care measures. The nurses should be understanding and supportive companions of the patients. Often these care services work closely with the SAPV teams.
Outpatient hospice services
Provide outpatient hospice services no medical or nursing service in the proper sense. Palliative care patients receive psychosocial and spiritual care from the hospice services. They help those affected, for example, to cope with the household or go for a walk with them and help seriously ill people and their relatives to cope with their stressful situation.
Domestic help during palliative care
Another way to avoid hospitalization is to avoid hospital admission regularHospices. Hospices are not understood as nursing homes, although in most cases the patients also live in the hospice. In these facilities everything that could create a hospital-like atmosphere is avoided wherever possible (apart from the necessary medical equipment).
The hospice work is carried out by both Doctors, nurses and physiotherapists, as well as psychologists, psychotherapists and social workers accepted. In addition to representatives of all faiths, many volunteer companions work in hospices and in the outpatient hospice services. Some hospices also offer the option of looking after and accommodating palliative patients only during the day, so that they can spend the night in their own home.
Palliative care in nursing homes
The scope and type of palliative care in nursing homes depend to a large extent on the attitude of the sponsors and the home management and, last but not least, on the nursing staff. Before going to a nursing home, you should therefore check whether the policy and philosophy of the facility are in line with your own wishes. It is not only the handling of palliative care that is decisive. How to deal with the death of other roommates and the support offered for relatives should also be found out beforehand. Whether and how a hospitalization in the last phase of life in the respective hospice is avoided should be checked in advance.
Find outpatient palliative care teams and hospice services
Anyone who would like to find out more about palliative care offers in their area can do so Use the offer of the DGP (German Society for Palliative Medicine e.V.). The DGP provides a search function * on its website that uses the postcode to show suitable service providers and facilities in the area.
(* http: //www.wegweiser-hospiz-palliativmedizin.de/)
Who pays for palliative care?
According to the amendment to SGB V (Social Code Five), the costs for palliative care at home are borne by Health insurance of the person concerned. The costs of inpatient palliative care must also be borne in part by the health insurance company.
People who are entitled to palliative care according to Section 37b of SGB V do not have to bear the costs of outpatient care themselves. The health insurance companies bear the costs of care and negotiate appropriate contracts with suitable care providers such as SAPV teams and outpatient hospice services. The costs of staying in a palliative care unit in the hospital are also covered by the palliative patient's health insurance.
people that Palliative care in a nursing home or old people's home must cover the cost of room and board at the facility continue to carry yourself. However, palliative care is financed by the health insurance companies. If long-term care insurance has been taken out, the costs for the stay in the care home will be subsidized or covered by this. The exact amount of the benefits to which he is entitled depends on the care recipient's degree of care. (Note: Since 2017, the care levels have replaced the care levels.)
Advice, support offers for patients and relatives, as well as voluntary support are in each of these cases free and are partly financed by the health insurance companies. In addition, the hospices are subsidized by the health insurances in order to attract volunteers and train them for palliative care, as well as to train specialist staff accordingly.
Palliative care for dementia patients
Dealing with dementia patients in particular is very complicated due to their condition. Most people with dementia can no longer walk without help and need help with eating and drinking. The sick can no longer communicate with their environment to the usual extent. They lose memory and language so that they can no longer communicate needs and pain. It is therefore difficult to pinpoint the beginning of the last phase of life in patients with dementia.
Senior with a carer in their own home - terminal care
The actions and reactions of dementia patients can usually not be clearly interpreted and are therefore difficult to interpret. Statements about the condition of the patient are only possible for medical professionals in exchange with people from their environment in order to gain different impressions. These people include the family and close friends of the person suffering from dementia, as well as the general practitioner and any nursing staff employed.
Release from work for "accompanying the last phase of life"
Everyone also has the opportunity to "accompany the last phase of life" of a dying relative for three months (permanently or part-time) to be released from work. This is an unpaid leave of absence. If the caregiver needs financial support during this time of palliative care (terminal care), he has according to the Family Act §3 Eligibility for an interest-free loan at the Federal Office for Families and Civil Society Tasks (BAFzA).
The prerequisite for this is a Relationship up to the second degree with the care recipient. These include: direct relatives (children, parents, siblings, etc.), grandparents, in-laws and step-parents, spouses and life partners, brothers-in-law, as well as adopted, foster children, in-laws or grandchildren. In addition, a appropriate form and a medical certificate be presented to the employer in order to be able to assert the right to exemption.
24-hour care as a supplement to palliative care
With models of palliative care in your own home, it is advisable to make use of the services of 24-hour care. We have summarized the advantages of 24-hour support for you:
- A contact person around the clock for those affected,
- psychological and social support,
- Help in the household, in everyday life and in leisure time and
- Relief for relatives.
PROMEDICA PLUS can offer you this service for every level of care. The trained support staff from Eastern Europe is placed according to high quality standards. The use of these two care models offers the relatives and the sick the optimal addition.
Get in touch now and receive a completely non-binding and free initial assessment.
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