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  • ProHospiz

    Mul cultural and prac cal oriented Guideline for establishing pallia ve

    care services

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    Title: ProHospiz. Multicultural and Practical Oriented Guideline for Stablishing Palliative Care  Services 

    Coordinator:  María Pilar García de la Torre. University of A Coruña, Spain 

    Authors: 

     Simone Jennewein. Diakonie Zentrum Pirmasens, Germany   Pavel Grabowski. Onkologische Hospizstiftung Podlaskie, Poland   Ramóna Dicu. Sfântu Gheorghe Rumänien, Romania   Kinga Dénes. Sfântu Gheorghe Rumänien, Romania   Ulrike Busch. Deutsche Ev. Kirchengemeinde Porto, Portugal 

     

    This project has been funded with support from the European Commission (Grant: 2014‐1‐DE02‐ KA204‐001583). This publication reflects the views only of the authors, and the Commission cannot be  held responsible for any use which may be made of the information contained therein. 

  • 1

    TABLE OF CONTENTS

    Preface …………………………………………………..…………………..…………………………………………………………………..2

    Introduction …………………………………………………………………………………………………………………………………….3

    1. Forms of hospice services and their functionality ....................................................................... .4

    Germany .................................................................................................................................4

    Romania ..................................................................................................................................8

    Poland .................................................................................................................................. 10

    Portugal ............................................................................................................................... 13

    2. Staff management ...................................................................................................................... 17

    Germany .............................................................................................................................. 17

    Romania ............................................................................................................................... 18

    Poland .................................................................................................................................. 19

    Portugal ............................................................................................................................... 20

    3. Communication with stakeholders ............................................................................................. 23

    Germany .............................................................................................................................. 23

    Romania ............................................................................................................................... 25

    Poland .................................................................................................................................. 26

    4. Death in cultural context ............................................................................................................ 31

    Germany .............................................................................................................................. 31

    Romania ............................................................................................................................... 38

    Poland .................................................................................................................................. 43

    Portugal ............................................................................................................................... 46

  • 2

    PREFACE

    We live in a time of profound changes and rapid developments. Value systems and social structures are

    under closest scrutiny. An increasing individualization and pluralisation has brought not only a liberation

    of the questionable social norms. It has made it difficult to find a common response to the challenge of

    time. The question of "common sense" is harder to answer than ever. Not to mention, that in many

    areas in Europe a lack of financing resources makes it harder to live together in the own country and

    with other countries. The described changes are also reflected by the experience of suffering, illness,

    dying, death and grief.

    In this guideline, as a result of the "EU project - Pro Hospiz", in the field of hospice work, money is not

    the issue. It is about considering the living conditions in five European countries and highlighting the

    differences and rather the commonalities. This project deals with the exchange of experiences and

    communication between the project partners. Only in this way Europe can move ahead.

    Just in the last few decades life expectancy of people in many countries has grown significantly (e.g. as

    much as 20 years in Germany). At the same time many people experience their last stage of life not at

    home, death gets repressed. On this background, hospice work is gaining more and more importance

    throughout Europe.

    This guideline gives a very good overview of the different requirements and organization of hospice and

    palliative work in five European countries. According to these descriptions, the guideline wants to

    encourage and facilitate the hospice work in other cultures and contexts. It is also a first guidance for

    practical implementation.

    It is a document that shows that Europe can only develop through exchange and communication,

    although this is sometimes a difficult road. Life to share until the last minute belongs to this road.

    I thank all those who have followed this hard road in the last two years and worked with passion to

    create this guideline.

    Norbert Becker

    Theological Board Member DiakonieZentrum Pirmasens

  • 3

    INTRODUCTION

    In the ProHospiz Project, an Erasmus + Strategic Partnership, five different institutions from five

    European countries have participated in the development of this practical and multicultural guide.

    The partners of the Project brought their different experiences and backgrounds:

     Institutions with a job based in palliative care through hospices as Diakonia Centrum in

    Pirmasens (Germany), which has acted as coordinator of the project

     Institutions with experiencor in hospitals, such as the Oncology Hospital Foundation of Podlas

    (Poland)

     Institutions providing home cares in rural environments such as Diakonia Foundation of the

    Reformed Church of Transylvania (Romania)

     Organizations interested in the implementation of care services in their own countries, as the

    German Protestant Church in Porto (Portugal).

    This is a practice-oriented guide, with a clear intercultural orientation and revised in its pedagogical

    aspects by the University of A Coruña, which has extensive experience in higher adult education and the

    implementation of European projects.

    This guide is the result of four transnational training activities and the consequent exchange of best

    practices throughout the two years of the project.

    The contents have been created for being used in the launch of new services, for improving the quality

    of the services already rendered and the implementation of good practices adapted to the various

    social, economic and cultural needs of each European country.

  • 4

    1. Forms of hospice services and their functionality

    According to the WHO hospice and palliative care is an active, comprehensive and holistic care of

    patients with incurable and progressive disease in the last section of their lives. The terminally ill person

    and his/her relatives who take care of him/her are accompanied by professional care.

    The goal of palliative care is to improve the quality of life of the patients and their families. Palliative

    medicine includes relief of pain that is difficult to control and relief of other physical symptoms, as well

    as relief of mental, spiritual and social suffering. Not to mention the support of the family in the course

    of the disease and at the end of life.

    The beginning of the development of the modern hospice leads back to the year 1967, as Cicely

    Saunders founded the first hospice in London. In this first chapter we are going to show 4 different ways

    in which palliative care and hospice are being developed in Germany, Romania, Poland and Portugal,

    according to the different cultural and economic reality of their societies.

    Germany

    Legal framework and the conception of inpatient Hospice

    The main issue of hospice work is the outpat