What is hospice home health

Palliative care: at home, in the hospice or on the palliative ward

In the past 25 years, a broad network of outpatient and inpatient hospice and palliative services has developed in Germany. This makes it possible to provide palliative care to people in the last phase of life individually and tailored to their life situation - at home, in the hospice or on the palliative ward. In all forms of care, the focus is on the dying person with his or her wishes and needs.

Palliative care at home: general outpatient palliative care (AAPV)

In the home environment, care is usually provided as general outpatient palliative care (AAPV). At the AAPV, general practitioners and specialists as well as outpatient nursing services take care of the seriously ill and their relatives. The nursing service has a basic qualification in palliative medicine. Support often comes from outpatient hospice services, which also take on coordination tasks. In this setting, it is usually possible to stabilize the patient sufficiently. In the case of symptoms such as pain, nausea, shortness of breath or in crisis situations, general practitioners have also been able to prescribe symptom control by nursing staff since June 1, 2017. This is done in the context of home nursing (HKP) on prescription. The nursing services and doctors involved in the AAPV are only employed to a small extent in the care of palliative patients.

SAPV: When is specialized outpatient palliative care necessary?

However, sometimes the symptoms of those affected are too complex or too severe. Patients need - temporarily or long-term - the support of a special palliative team (Palliative Care Team). One speaks therefore of specialized outpatient palliative care (SAPV). This service was introduced in 2007 and must be prescribed by a doctor. For those with statutory health insurance, all costs are covered by the health insurance company. In principle, every patient is entitled to it, but only some of those affected need this special form of care.

In contrast to general outpatient palliative care, only palliative physicians and palliative care nurses are deployed at the SAPV. They advise and care for the patient around the clock if necessary. The SAPV team works closely with nursing services, resident doctors, hospitals and hospice services, especially if the SAPV was prescribed purely as an advisory or coordination service. If necessary, the SAPV team can also provide partial or complete patient care.

Hospice or palliative care unit: when it is no longer possible at home

If a dying person cannot be cared for in his home environment without the need for hospital treatment, an inpatient hospice offers the appropriate care framework. Those affected and their families can find professional and psychosocial support and support here around the clock. This is usually done by full-time and voluntary employees who are supported by a palliative care specialist. At the same time, hospices offer a protected setting in which relatives and those affected can say goodbye. A hospital atmosphere is deliberately avoided. The stay in the hospice is largely covered by the health insurance companies. Any remaining costs are financed by hospices through donations.

In the case of severe acute symptoms that cannot be adequately controlled on an outpatient basis, the patient can also be transferred to the palliative care unit of a hospital. With a wide range of medical and nursing measures, the palliative medicine specialists and palliative care staff try to stabilize the patient again. The aim is to release the person back home if possible.

Outpatient hospice services: psychosocial and spiritual support

Most people want to spend the last phase of their life in their familiar surroundings. Outpatient hospice services support them with psychosocial and spiritual support. Volunteer hospice attendants, for example, take on seat watch, provide information, offer discussions or support the families in the household. They do not take on medical and nursing activities.

A full-time palliative care specialist acts as the coordinator. She maintains contact with volunteers and relatives and networks the other professional groups. In the event of pain or restlessness, it is possible to react quickly. Use of a hospice service is usually free of charge. (ne)

10/17/2017 | Palliative care | Online article

Palliative care: giving the days more life

Palliative care refers to an interdisciplinary and multi-professional concept that is dedicated to the care and support of seriously ill and dying people.