Care of Critically III and Dying People of Advanced Old Age in Nursing Homes Policy Paper on the Establishment of Hospice Culture and Palliative Care in Nursing Homes

摘要

The care of critically ill and dying aged people and their family represents an especially difficult challenge for the medical and nursing staff, as well as for the facilities where these people live. Since an increasing number of people will spend the last phase of their life in nursing homes, the implementation of hospice culture and palliative expertise in geriatric nursing homes is of fundamental significance. The German Association for Palliative Medicine and the German Hospice and Palliative Association have convened a joint working group to support the implementation of palliative care. The working group has worked out this policy paper on the care of seriously ill and dying people of advanced age in nursing homes. The purposes of this paper are closely related with the further implementation process of the "Charter for the care of the critically ill and the dying people in Germany". The policy paper describes the current stage of provision of palliative care in nursing homes, the objectives for the integration of hospice culture and palliative care provision, as well as the measures needed to achieve these aims. Hospice culture and palliative nursing should become integral parts of the care program in every facility. It is of fundamental importance that regional networks for hospice-palliative nursing will be developed, including hospice and outpatient palliative care services. It is a moral obligation to consider the needs of critically ill patients of advanced age to make an appropriate and comprehensive palliative/hospice nursing care available to all who need it. This includes treatment and relief of physical symptoms, a comprehensive nursing care as well as psychosocial and spiritual support. Problems and concerns of the patients' families must also be taken serious and addressed equally.