Hospice

Hospice (Latin hospitium " inn" ) is an agency of the dying. In the German -speaking area of the present is usually referred to as a hospice residential care facility that has usually over a few beds and is organized similar to a small nursing home. The first inpatient hospice was opened in 1967 in the United Kingdom ( in Germany 1986), there arose in 1982 the first children's hospice ( in Germany 1998). In Germany there are 179 hospices and palliative care units in 231 hospitals and more than 1500 outpatient hospice services.

Basics

Hospices have made it their mission to provide terminally ill patients in their last phase of life in the sense of Palliative Care. There are outpatient, day-patient and in-patient hospice active associations, so service providers in hospice and palliative union area. A database for research hospice and palliative care providers, the guide hospice palliative care and Germany ready.

In a hospice is an institution that pursues a concept of death and grief counseling. Hospices want to realize five quality criteria ( by Christoph Student, 2004):

• The patient and his family are at the center of service
• Support is provided by an interdisciplinary team
• Involvement of voluntary escorts
• Palliative care ( care for pain relief and quality of life) instead Medical Cure ( aimed at healing treatment), briefly, this means that quality of life rather than quantity of life
• Funeral

In hospice dying and their families guidance, counseling, and medical and nursing care. The control of the various symptoms plays a major role, including pain management. In all nursing and medical actions but is the ( expressed or presumed ) will of the sick in the first place. In addition, grief counseling is offered for families.

Support of these houses of-life care are usually nonprofit associations, but also churches and non-profit organizations and foundations. The medical care is guaranteed different. Some hospices are under medical supervision, others work with doctors practicing together on site, where the patient can exercise his right to free choice of physician claims. Then it is often the long-standing family doctor of the patient, which takes over the medical and human accompanied by his patients until his death. These do not necessarily need for a specialist training in palliative care, but they can be beneficial.

A hospice falls in Germany legally under the Nursing Home Act. Some paragraphs must be applied in the hospice but not.

History

In 1967, St Christopher's Hospice in Sydenham was founded ( in London). From there, the current hospice movement began. The history of hospices stretches back further.

A hospital or Hospitium was in the Middle Ages name of church or monastic hostels for pilgrims ( pilgrim hostel), needy ( poor house ), strangers (asylum, compare hotel) or the sick, and goes so then later on the term about which the present hospital converts.

The original idea of the "Accommodation " was again taken up in the 19th century. Already in 1842 founded Madame Jeanne Garnier in Lyon ( France) a hospice dedicated specifically to the care of the dying. 1879 opened the Irish Sisters of Charity, the Our ​​Lady 's Hospice for the Care of the Dying in Dublin. There were other hospices, which can be regarded as a precursor to the establishment in Sydenham.

The modern hospice movement and palliative care emerged, however, in the 1960s in England and go far back to Cicely Saunders. In which she founded St Christopher 's approximately 2000 patients and their families are cared for each year. The international hospice work was strongly influenced by the work of Elisabeth Kubler- Ross. In Germany, inter alia Christoph student has contributed much to the development of the hospice movement. The first inpatient hospice in Germany was founded in 1986 in Aachen ( Horn House ). He subsequently produced more hospices, mostly founded by citizens' groups, associations and religious institutions; initially funded almost entirely by donations and supported by volunteer work.

Under the name Federal Association Hospice ( Hospice BAG ) was the German Hospice and Palliative Care Association ( DHPV ) founded in 1992 by the hospital chaplain Henry Pera in Halle ( Saale). The aim is to spread the hospice movement and the merging of interested individuals as well as joint development of guidelines and recommendations for outpatient and inpatient hospice care. Association members of DHPV led multiple conversations with representatives from insurance companies and ministries and members of parliament to create a legal basis for the financing of hospice care. This was achieved in December 1996 with the approval of the German Bundestag to § 39a SGB V, its practical implementation has been written in the framework agreement between BAG and health insurance. 2007, there was to change the name of BAG hospice DHPV. The Association has developed together with the German Society for Palliative Medicine and the German Medical Association a charter for the care of seriously ill and dying people. It was adopted on August 17, 2010.

In 1995, the German Hospice Foundation was established to represent the interests of severely ill and dying. Since 2012, they called German Foundation patient protection. The Foundation runs itself no hospice facilities, but continues, as well as the DGP and the DHPV, one for self-determination and care at end of life and represents the interests of nationwide seriously ill and in need of care in relation to politics, health insurers and providers. Like the other hospice and palliative associations, the Foundation is working on a societal level to improve the situation for the seriously ill. Hospice of living to become a reality for each of the approximately 800,000 dying annually in Germany, is the core requirement. For this purpose it was necessary to realize the hospice thoughts wherever people die - whether in nursing homes, in hospitals or at home.

Hospices today are usually health professional and be - largely financed by the health insurance companies - also due to the constant political work of the German Society for Palliative Medicine, the German Foundation for the protection of patients and the DHPV. Previously paid hospice patients to a contribution of an average of seven percent, which is omitted by decision of the German Bundestag on 18 June 2009. Since August 1, 2009, health insurance companies contribute 90 percent of eligible costs ( day care set). Ten percent of the nursing record must continue to apply hospices themselves, including most of the donations are used. Even donations are used when patients are admitted who are not insured for various reasons (eg, the homeless ). The statutory 10 percent equity share of stationary hospices are regularly rated as unrealistic. In fact, hospices would bear some 30 percent of the cost, which is due to an unsuccessful negotiations with health insurance to the daily needs related sentences.

The first Austrian initiatives started in the late 1970s under the auspices of Caritas Socialis (CS Hospice Rennweg ) in 1998 awarded the Prince of Liechtenstein Award for its initiatives for the first inpatient hospice in Austria.

Importance for life

Hospices want to integrate the dying back to life. The sick and their families to a bit of normality are taught, which is often not given in the hospital or at home ( by overtaxing of carers ). According to surveys, want to die at home about 90 percent of all people. In fact, however, die, according to estimates about 50 percent of people in the hospital and another 20 percent in the nursing home. ( For Berlin for 2007, the number was called 70 percent. ) Hospices want this to be a decent alternative if hospital treatment is no longer wanted or for medical reasons is not required ( and is therefore no longer paid for by health insurance ); a nursing home does not come because of inadequate medical and nursing care options for severe disease in question.