Palliative care explained: SAPV, AAPV and hospice | Dr. Andrea Morawe
A topic that affects us all at some point, yet is discussed far too rarely, is dying.
In this episode, Dr. Andrea Morawe aims to provide information, reduce uncertainty, and help people better understand end-of-life decisions. Especially during this phase, dignity, support, and good care are paramount.
Palliative care begins the moment it is determined that an illness is no longer curable.
Palliative care doesn't mean giving up, but rather shifting the focus. It's about alleviating pain, controlling symptoms, maintaining quality of life, reducing anxiety, and considering the individual holistically—physically, psychologically, socially, and spiritually.
For this reason, palliative medicine should not be a taboo subject. It is often referred to as BSC, or Best Supportive Care.
General outpatient palliative care (AAPV) provides basic care for people with an advanced, incurable illness who are still relatively stable overall. This care usually takes place in the home environment and is provided by general practitioners and outpatient nursing services.
The focus is on pain and symptom control, close communication with family members, and the organization of support services. This includes contacting the long-term care insurance provider and involving volunteer helpers.
The goal of general outpatient palliative care (AAPV) is to avoid hospital stays whenever possible and to maintain stability in daily life.
When symptoms become increasingly difficult to control and 24/7 availability is necessary, specialized outpatient palliative care (SAPV) is used.
Both AAPV and SAPV are covered by statutory health insurance if prescribed by a physician.
Many people express the wish to die at home. However, continuous care must be ensured for this to happen. This is often provided by family members with the support of outpatient nursing services.
For patients, the emotional burden is often lower in familiar surroundings. For family members, however, it is usually significantly higher. Therefore, an honest and realistic assessment is crucial. Not every wish can be fulfilled in the long term.
A hospice can be a very good alternative in this context. Hospices are not hospitals, but rather places of support and care. Here, time is available for patients and their families, and a dignified end of life is made possible.
The costs of hospice care are high, and according to Andreas, this work is not sufficiently valued by society, as a large part of it has to be financed through donations.
Importantly, no one is turned away from a hospice. There are no costs for patients or their families.
Bureaucracy also plays a role at the end of life. After death, a death certificate is issued. This service is not covered by statutory health insurance, as insurance coverage ends with death. The bill often arrives unexpectedly for relatives and presents an additional emotional challenge in an already difficult situation.
If this episode of LandMEDchen has helped to initiate conversations about the end of life or to reduce inhibitions, then it has achieved its goal.
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Chapters:
00:00:00 Palliative Care
00:03:11 AAPV and SAPV
00:07:50 Dying at Home
00:10:52 Dying in a Hospice
00:15:40 Bureaucracy