gms | German Medical Science

Aims: The project shall provide an early contact between patient/relatives and the ambulatory hospice services for a continuous holistic support of palliative tumour patients within the hospital as well as to provide a future ambulatory support. Therefore prejudices should be diminished, in particular the widespread opinion, that the Hospice Movement is only going to take action if death is imminent. The support of the hospice services should be offered to all palliative tumour patients and their relatives at an early stage.

Methods: The hospice group in Offenbach has taken initiative at the Ketteler Hospital. Since January 2004, the hospice consultation takes places at the site of the psycho oncology of the Ketteler Hospital with the presence of two hospice helpers fortnightly on Thursdays from 4.30 to 6.30 pm. For the stationary patient an oncology coordinator clarifies which in-patients come into consideration for the consulting hour with the physicians and the head of the station. The psycho oncology service (three doctors) will personally offer the patients a consultation of the ambulatory hospice support whilst the patients stationary abidance. If the patient agrees, the hospice helpers will be informed about the diagnosis, conditions of the treatment and the prognosis. The process of the discussions will be documented briefly. Additional desired visitations will take place beyond the consulting hour, as well as for patients which are hospitalized in the Ketteler Hospital for only fourteen days. Awareness training, patient seminars and co-worker training accompany the project.

Results: Starting January 2004 until October 2005, 341 tumour patients were treated at the Ketteler Hospital, thereof 130 patients were selected for the hospice helpers. Sixty-two (47 %) of the patients und their relatives have accepted the offer. Contacts without previous preparation were infrequent, this points out on additional fear of contact. It was remarkable that especially relatives asked for further contacts. Via ambulatory palliative care, it was possible to provide permanent care for the patients/relatives rather then to call for hospice group support. The project will proceed and will be extended by a palliative telephone consultation for personnel, patients and hospice groups.