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A hospice is a medical institution in which incurable patients are treated in the last stage of the disease. Tired and emaciated people stayed in such establishments.
Currently, incurable patients are living in these institutions, whom official medicine can no longer help. It's time to debunk the main myths about hospices and understand how much society really needs them.
Hospices have recently appeared in Russia. In Moscow, a specialized institution of such a plan for cancer patients appeared in 1903. The initiative came from the famous oncologist, Professor Levshin. For several years he raised funds through charity. On Pogodinskaya Street, a four-story building with 65 seats has appeared. For that time, it was an advanced institution, here preparations with radium were tested. But in the 1920s, the institution lost its original functions, turning into a research clinic. In our time, the first hospice opened in St. Petersburg in 1994.
Getting a patient to a hospice means his quick death. Do not take this place as a death house. Palliative care can improve the quality of life. We are talking about the elimination of pain, proper nursing care, support from a psychologist. A hospice stay is not a preparation for death, but an attempt to make life as dignified as possible until the very end.
Only cancer patients are admitted to the hospice. Access to palliative care is needed for anyone with a chronic life-limiting illness. International studies have shown that 70% of patients with such problems can qualitatively improve their lives through palliative support. This includes people with heart disease, kidney disease, lung disease, dementia, or kidney failure. Even patients with chronic diseases find support here, learn to deal with their problem every day, stay active and feel better.
In hospice, pain syndromes are reduced only with the help of drugs. Palliative care provides a range of measures. People are taught to manage pain through spiritual and psychosocial care. The very term "all-consuming pain", which is used in hospices, includes not only physical suffering, but also psychological, spiritual, and social. This general tension must be relieved. In palliative care, there is room for narcotic painkillers, but the course is not limited to them alone.
Palliative care is provided only in the hospice. There is a mobile hospice service that provides palliative care at home. Doctors and nurses can teach relatives how to properly care for patients, instill in them the philosophy of hospice. The fact that a person can no longer be saved does not mean that it is impossible to help him.
Hospices are for the elderly. Hospices, along with a palliative care program, are available to patients of all ages. I don't want to think that children can suffer from incurable diseases. In practice, however, a significant part of hospice care relates to babies with fatal or life-limiting diseases. Palliative care programs themselves should ideally be prepared for patients of all ages. There are some shelters that are specifically for children.
All those in need receive palliative care. The World Alliance of Palliative Care Organizations indicates that only one in ten patients receives the required support. And these are the average figures for the world, in Russia it is still worse. At present, only 40% of patients are provided with palliative care in Moscow hospices. Without full-fledged such support, the medical care system in the country cannot be considered complete. The incurable patient should be able to receive hospice care from specialists.
People live in hospices for several days. It seems that in hospices, patients manage to live only a few days, the bill goes for weeks at best. But the largest insurance companies in the world offer hospice services for six months. If the patient managed to save his life, then he can stay here further, or return here at any time. Sometimes leaving a team of professionals works wonders. Here they see people in patients, and not a difficult diagnosis. As a result, good care allows many to live longer than doctors predicted.
Getting into a hospice means giving up the fight. Hospice patients never give up. Employees continue to fight for the patient's life, offering relatives to do so. Nursing focuses on hope. People are trying to convince people that they will not feel pain, that they will soon be able to go outside, see their grandchildren at the weekend, and celebrate the upcoming anniversary. One must always hope for recovery, at the same time, one must prepare for the probable future.
Hospice hastens patient death. Many are afraid of going to hospice, believing that they will end their lives there faster than at home. In fact, numerous studies have shown that people with the same diagnosis live longer in hospice as opposed to those who do not. The institution makes it possible to live more of the last days, moreover, of better quality.
Hospice requires a receipt for denial of resuscitation. Some hospices require such a receipt, while others do not. To get a place in a hospice, such paper is not at all required. In fact, the document says that in case of cardiac arrest, the patient refuses to try to start the organ with an electric current. The fact is that it is fraught with rib fractures. Such paper allows you to give permission to a person to leave without torturing the staff and yourself. But the signature can always be revoked. The purpose of hospice is to help the person, not to demand something from him.
It is better to die at home than in a hospice, hospital, or nursing home. Hospice is not a place, but support from a team of professionals. They work with people wherever they are. Hospices can be located in homes, apartments, caravans, homeless shelters, nursing homes, and special hospitals. The hospice should be in the place that the patient himself considers his home.
Hospices stop giving medications. Often people even in their last days take medicines from a long list. Avoiding some of them can actually increase your well-being or improve your appetite. If there is a diagnosis that leaves a few months of life, then there is no point in lowering cholesterol or treating osteoporosis. While in the hospice, you can eat as many eggs or ice cream as you like! Why not indulge in strawberry whipped cream? In any case, doctors will give recommendations on what medications it makes no sense to take, but the final decision remains with the patient himself.
Hospice makes patients addicted to drugs. In very small doses, drugs can be effective in relieving pain and improving breathing. The medical team has extensive experience in the use of drugs, giving them in such a volume that the patient can feel better and maintain the same lifestyle. Doses are given in small amounts so that they do not lead to a loss of consciousness and do not lead to addiction. Those who are afraid to take drugs may ask the nurse to stay with them after the first dose, assessing their comfort.
Hospice is expensive. In the West, hospice services are covered by private insurance companies. Many shelters have their own funds to cover expenses or are looking for some way to find funds.
Getting into a hospice means that you will no longer be able to communicate with your doctor. Doctors in the hospice work closely with the treating doctors. Together they will create the best treatment plan for the patient. You just need to inform the hospice that consultations with your doctor will continue.
Hospice means giving up your own decisions. The hospice is built around a plan set by the individual. The patient seems to be traveling in transport, choosing his own path. Everything around helps to make the car run smoother.
Hospice provides 24/7 care. The hospice team is available 24/7, providing assistance and medical care. But the team never takes responsibility for caring and does not promise to provide ongoing care, responding instantly to all problems. Not all hospices are able to constantly monitor their patients, this should be taken into account.
All hospices are the same, regardless of whether they are commercial or charitable projects. Each hospice must provide specific services, but often the path is different. Just as there are many business models for starting a restaurant, there are also options for providing care in such establishments. And families sometimes need to know if they are dealing with a business or a charitable organization. Keeping a patient in a hospice can become very expensive if there is no insurance.