In the future, more and more dying people will have to be cared for in hospices and nursing homes. But the facilities are struggling with staffing concerns – and training is often scarce.
Susanne Studemund enjoys life – despite her incurable illness. The 63-year-old has been living in the hospice at the Israelite Hospital in Hamburg since August. In May, a diagnosis changed her life: she has glioblastoma, a malignant brain tumor. She had to be resuscitated twice. Operations and many hospital stays followed.
The hospice now gives her peace and security. Here she was able to regain her strength. “It’s a relaxed, happy atmosphere,” says Studemund. “Even if you’re lying in your room, seriously ill, you hear these normal everyday noises, like laughing, running and talking – then that’s great, that’s life and it goes on.”
Not residents, but guests
In contrast to a palliative care unit in a hospital, there are no set times in the hospice. The residents, here called guests, can get up, eat and have visitors whenever they want. The atmosphere remains familiar.
The focus is on the guest and their relatives with their individual needs, says hospice director Bettina Orlando. “What is very important is that we approach people without judgment. Dying with dignity means something different to everyone and we try to make that possible.”
“Dying should be something everyday for us”
You can never predict how long a guest will stay; some people move out again. But for most it is the place of the last phase of life. When a person dies in the hospice at the Israelite Hospital, a flower comes to their door. The flower stays until the guest leaves the house. A candle will be lit in the memorial room.
“Dying should be an everyday occurrence for all of us, because none of us make it out of this life alive,” says Orlando. “But what’s special about the hospice is that you can give life even to the dying. Everyone does it the way they prefer, according to their own wishes. It’s a final home.”
Donations and volunteers are important
There are around 1,500 outpatient hospice services and 260 inpatient hospices in Germany. Inpatient hospices are 95 percent financed by health insurance companies, five percent are generated through donations.
Hospice work also depends on volunteer commitment. But finding good staff is also a challenge here. Because hospice and palliative work is not a focus of nursing training. Two weeks are planned for practical use in the palliative care area. “Palliative care is so individual and varied. Especially here it would be very valuable to be trained more intensively, also in order to retain nursing staff,” says Kirsten Mainzer from the Hamburg State Association for Hospice and Palliative Work.
Due to demographic change and changing family structures, more and more people need to be cared for in hospices and nursing facilities. “Palliative care in inpatient care facilities must be guaranteed in the future, even if the nursing shortage increases,” said Mainzer. “For this purpose, it would be desirable for the health and nursing care insurance companies to finance palliative care officers in care facilities.”
On October 17th, the Bundestag will debate how palliative care and hospice work can be improved in Germany. World Hospice Day, which takes place every year on the second Saturday in October, is also intended to draw attention to the topics of death, dying and grief and to remove taboos from them.
“I live much more intensely than before”
Susanne Studemund has already planned her funeral: it will be a burial at sea. “My ashes will then be distributed and wherever my relatives are, whether on the Elbe, the Baltic Sea or the North Sea, there I am.” The 63-year-old is grateful for life – also thanks to the people who make it possible for her. “I’ve always said that I have a nice life, even after the diagnosis. I live much more intensely than before. I would never have known that if I hadn’t gotten the diagnosis.”
Julia Wacket, NDR, tagesschau, October 12, 2024 3:45 p.m