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Palliative care in Germany Great regional differences
Only a few Germans want to die in the hospital. However, the reality is different: The majority of Germans do not die as desired at home. A new study by the Bertelsmann Foundation outlines the reasons for this.
Most want to die at home
In recent years, various polls showed that most Germans want to die at home. 75 percent would prefer death at home, but the reality is different: every second senior citizen dies in a clinic. This gap between reality and intent shows a new study by the Bertelsmann Foundation, which has now been presented. The subject of the "Health Facts Check" is the expansion of palliative care in Germany. This week, the Bundestag wants to adopt the Hospice and Palliative Act, which should enable better care for dying people.
Big differences in the supply. Picture: Photographee.eu-fotolia Regional differences and supply gaps
Particularly striking are regional differences and care gaps especially in outpatient treatment, the news agency dpa reports. In a quarter of all circles in Germany, therefore, specialized palliative care physicians are missing. By contrast, more than twice as many physicians in Hesse have additionally qualified palliatively as in Thuringia. Palliative medicine is used when there is no chance of recovery in a very advanced disease and life expectancy is limited. It is about improving the quality of life and not extending the lifetime. For the most part, elderly patients are affected, but also a palliative care for children with diabetes takes place.
Supply patients at home
According to the Foundation, Baden-Württemberg, Hesse, Lower Saxony and Schleswig-Holstein are home to a large number of outpatient palliative care physicians who care for their patients at home. In these states, the rate of death of people who die in a clinic is correspondingly lower. Where in-patient services are greatly expanded, more people die in hospitals than in federal sections. The experts at the Bertelsmann Foundation are calling for the expansion and further development of palliative care: "In doing so, being outpatient in front of inpatient and general specialist," explained project manager Eckhard Volbracht.
Expansion of outpatient care must take precedence
Foundation Board Brigitte Mohn demanded: "The planning of new care offers should be based on the desire of most people to spend their last days at home." Therefore, the expansion of outpatient care must take precedence over an expansion of in-patient services. Exemplary here is a model in Westphalia-Lippe, where the family doctors have been coordinating palliative care since 2009. Last year, about 20 percent of the deceased were cared for. Only 8.7 percent of these palliative patients died in a clinic.
High awareness of patients
According to the study, there is still a high need for information among patients. "Nearly 90 percent of all people need palliative care at the end of life," said Lukas Radbruch of the German Society for Palliative Medicine. However, according to the study, in 2014 only 30 percent of the deceased received appropriate treatment during their lifetime. In addition, the treatment is often too late. "It does not help if patients are treated palliatively only for the last two to three days of life," says Volbracht. (Ad)