Esther Schmidlin, EAPC board member, and a nurse consultant, Equipe Mobile en Soins Palliatifs, Plateforme Santé Haut-Léman, Vevey, Switzerland
Poland has a long-standing tradition of hospice care (1). Last year, the first hospices celebrated their 30th anniversary. When visiting Poland – host of the EURO 2012 – for football reasons, I also took the opportunity to visit two hospices. Impressed by the history of the hospice development in this country, I was interested to learn about the similarities and differences in hospice and palliative care, and learn about the challenges that my colleagues in Poland are facing today. Throughout my stay in Poland and when writing these blogs, Piotr Krakowiak, the National Chaplain of Hospices, in Poland was a knowledgeable discussion partner allowing me to gain more insights into the history and current situation in his country.
Visit to Res Sacra Miser, Caritas Hospice, Warsaw
Caritas, as well as other Christian charities, is also very active in the field of hospice and palliative care. All together, there are more than 100 hospice/palliative care programmes run by the religious institution and, apart from the medical attention, spiritual care plays an important role.
The Caritas institution I visited in Warsaw has two different inpatient departments: a hospice unit with 25 beds for patients suffering from advanced cancer and a nursing home, which provides long-term care to 120 patients. Both services are in a beautiful old building, surrounded by terraces and gardens, in downtown Warsaw.
The inpatient hospice started in 1989 and provides care for patients with cancer, when hospice care at home is no longer sufficient. All usual medical treatments such as opioids, hydration and the necessary equipment such as syringe drivers are provided, and support to the families and spiritual care are equally assured through the staff and the daily visit of the chaplain.
The nursing home department, originally built as a care home for frail, bedridden and older people, has developed over the years into a specialist centre for patients with appalic syndrome (persistent vegetative state) and it is the biggest centre of its kind in Warsaw. Here, good care, as well as rehabilitation, is the main focus. Dr Barbara Kolakowska, head of department, explains that with physiotherapy, speech therapy and occupational therapy some patients do occasionally recover to some degree; and even wake up. However, most stay in a persistent vegetative state and will eventually die within one or several years.
One interesting feature in this institution is the group of about 50 volunteers, of whom 6-7 people are prisoners. The male prisoners are brought in daily to work in the garden, the kitchen, or to contribute to the maintenance of the house, but some are trained further and help in the daily nursing care of the patients. Starting as a pilot project about nine years ago in Poland, this arrangement has proved to be both appreciated and beneficial to all parties. To learn more about this initiative, click here to watch a short video with English subtitles. I would like to thank Dr Barbara Kolakowska, Andrzej Czarnocki and Ks Zbigniew Zembrzuski, the director of the hospice, for their generous hospitality and time. My thanks also to Piotr Krakowiak for his valuable input and boundless information about Poland’s hospices.
1. EAPC Development Task Force (2007). Country Report Poland
I’ll be writing two more posts about my visit to Polish hospices in the next few days – I hope you’ll join me!