End of life care - A concept for home and paEEiativs outpatient rrtartaqement

摘要

When there is no cure for an illness our attention turns to treating the unpleasant symptoms that our patients experience. This involves a broad spectrum of care with the terminal care often being called hospice and palliative care. The primary focus is controlling the patient's symptoms such as pain and shortness of breath. We also address ethical questions while dealing with psy-chosocial problems. This work is possible because of the cooperative structures of palliative care with their palliative care teams [Palliativer Konsiliardienst (PKD)]. There are 30 regionally organized palliative nets. The situation in Dortmund provides an example for these structures.The palliative nets provide the necessary support and palliative care for the patients. Most patients predominantly suffer from late stage malignancies. Those patients with other terminal medical diseases, such as chronic heart failure, end stage renal disease, cirrhosis, COPD and stroke, benefit tremendously when their symptoms are addressed. People can choose to die at home surrounded by those they love when the patient and family receive this type of palliative support. The established structures support general palliative care and enable a specialized ambulant palliative care. Ethical questions are resolved together with the patient, their caregivers and the palliative team. Informed decisions are made to discontinue certain treatments or to waive life-prolonging procedures. Hospital admissions are minimized in this way.