Hospice and palliative care – the holistic care and support of people with serious illnesses where a cure is no longer possible – is a comparatively young form of medical care. It comprises both voluntary and paid end-of-life care, as well as palliative medicine, palliative care and psychosocial-spiritual care. Most people, regardless of whether they already feel close to death or hope not to have to deal with this issue for a long time to come, want to be cared for and die at home, or at least in a familiar environment. This is not always possible. Either way, people’s desire to spend their final days in a caring environment plays an important role in planning hospice and palliative care suited to patients’ needs. At the same time, caring for seriously ill people at home is often an all but impossible burden for relatives, which in Austria is often passed on to frequently changing personnel with little experience in palliative care. In Austria, most 24-hour home care workers come from Slovakia, Romania and Hungary. Day hospices have proved their worth in large cities. The Caritas day hospice in Vienna opened in 2001, but has lacked public funding to cover its minimum needs from the very beginning.
24-hour caregivers need support in their daily work with terminally ill patients. The brochure Begleiten bis zuletzt (“With you to the end”) has been published in Romanian, Slovakian, Hungarian and Bosnian-Croatian-Serbian (BCS). While its main goal is to enhance the competence of professional caregivers with these mother tongues both in Austria and in their home countries – thereby relieving the burden on relatives – it also offers guidance and support to family caregivers caring for dying family members. Back in June 2007, we joined forces with the Austrian savings banks group and Erste Bank to support voluntary palliative care and hospice services, as coordinated by the Hospiz Österreich umbrella organisation. Besides training and further education of volunteers, we promote information events and workshops for further training and networking. An additional goal is supporting the expansion of the day hospice of Caritas Vienna. Day hospices offer treatment, counselling and guidance to palliative patients provided by a multi-professional team supported by volunteers. Additional psychosocial and therapeutic services help organise daily activities in the company of similarly affected people. The day hospice of Caritas Vienna complements and expands outpatient hospice care at home.
Experts in medicine and ethics are beginning to understand what those affected have known for a long time: for patients suffering from a terminal illness, the most important goal is not prolonging life, but achieving the highest possible quality of life. High-quality hospice and palliative care services offer comfort, relieving pain and other symptoms that impair quality of life such as fatigue, shortness of breath and nausea. Patients, caregivers, relatives and loved ones are all involved in decision-making. Working with our partners, our goal is to ensure nationwide availability of care by voluntary hospice caregivers, and generally improve care conditions in hospice facilities. Death is still a taboo in our society. We hope to change this – it is something that concerns us all.