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Hospice care or ‘palliative care’ is the provision of symptomatic treatment to those who are suffering from a terminal disease. It can be provided at several places including home, clinic or a hospital. In the UK, one of the first modern hospice centers was the St. Christopher’s in South London. It had opened in the year 1967, and has a significant impact on people especially those who are dying from a terminal disease. The hospice has been a very important development in the history of UK. For them, the hospice has been a social innovation, meant to help those in suffering.
It is meant to help those who are dying by helping relieve pain and suffering that can be avoidable using medicines and other forms of therapy. Many researchers have been motivated in the UK to develop a system by which pain and suffering can be reduced. In the UK, hospice care is provided by multidisciplinary teams that work in various fields to the cause of reducing the pain and distress suffered by the patient. The main philosophy on which the hospices function in the UK is that death forms a part of life.
Besides several other values such as respect, holistic care, compassion, choice, etc, are incorporated. Hospices in the UK provide fulfillment of the physical, mental, social and spiritual needs of the dying. Hospice care is provided at the home, in clinics and also in hospitals. Usually in the UK, hospice care is provided free of charge. Even the NHS provides hospice care free of cost. The average stay in the UK for a person in the hospice is about 13 days, which is much lower compared to the US (as more advanced technology is utilized).
Several services including pain control, nursing, counseling, alternative therapy, spiritual care, physiotherapy, relaxation techniques, family therapy, etc, are provided to help the dying enjoy a quality life (Hospice House, 2008). Another country, which has been enthusiastic about the development of the hospice, has been Germany. Most of the hospices that are present in Germany have been made by private initiative. In Germany, hospice care is provided in two broad categories, namely, outpatient hospice services and inpatient hospice services. In the outpatient hospice services, care is usually provided in the homes.
The life of people who are dying is improved through an inter-disciplinary team consisting of doctors, nurses, therapists, friends, family, social workers, volunteers and religious professionals. They strive to improve the quality of life of those who are dying from a terminal disease. On the other hand, the inpatient hospice services are provided in specially created hospitals. There are more than 85 small to medium sized hospitals in Germany that provide hospice care. Each of these hospitals contains units, and in each unit, about 8 to 12 patients are provided care.
Usually in these hospitals, patients suffering from critical conditions, with no hope whatsoever are given care. Most of the costs of treatment and hospitalization under hospice care are provided by insurance, brought about by a German health insurance law. The patients provide only about 10 % of the cost of treatment. In Germany patients are admitted to the hospice facility only for a short period of time, during which the terminal disease is in its critical stage. Most of the hospice centers and associations have been created on a private initiative.
These local hospices are connected through a local network, which in turn, is connected to a regional and then a national network. The Federal Hospice Association controls the activities of the hospices. This organization ensures that the hospices are following the laws as mentioned in the Statues of Germany. Several of the hospices in Germany also provide counseling services by specially trained professionals. One of the special requisites of providing hospice care at home is the need to undergo counseling. In Germany, hospice care began to make a true progress only in the 1980’s and the 1990’s.
About 6. 5 palliative beds are available for every one million population in Germany, as in the year 2000. Several of the German university hospital also has special palliative care units. One of the special features observed of German hospices is that the inpatient wards also have very good nursing and psychosocial standards. However, overall, the medical standards of care are much poorer in hospices in Germany compared to the UK. The research levels in hospice medicine in Germany are also very poor (Have, 2001 & Health & Age, 2003).