Hospice, what is it: a shelter for those waiting for a miracle or a hospital for the dying? Are they coming for religious reasons? The fruits of an atheistic upbringing

A terminally ill child... This tragedy can happen in the life of each of us, and then main question: where to look for support when there is no more hope. The motto of the children's hospice "House with a lighthouse" - "It's not about death, it's about life". The hospice cares for children with incurable diseases and it was their stories that formed the basis of a special project “ Time to live " on "D o machine". Premiere - 8 April.

Often friends and doctors tell moms that they can't do it alone when dads leave them. Children are not taken to kindergartens and schools, offering to "give birth to a second child." And the worst thing is that little patients are not provided with qualified medical care, doctors give up on them and do nothing while the child suffers from pain. “ Home ” will talk about hospice patients and their mothers, about doctors and people who have dedicated themselves to helping children, and will also try to destroy the myths about incurable diseases and how you can live with it.

Myth #1: You can't do it alone.

According to statistics, a third of fathers leave families with a disabled child and no longer participate in their lives. Young mother Daria Guseva has been raising Sashenka for three years now. The child suffocated during childbirth and now lives with a diagnosis of ischemic CNS damage. The girl does not see, does not hear, does not move, but lives and breathes with the help of a tracheostomy and an oxygen concentrator. The father abandoned the family as soon as he found out about his daughter's diagnosis and Daria's decision not to send the child to a boarding school. But the mother says that she is happy to be able to give her child the very best.

Myth two "Incurable children should not be taught"

Of the 198 preschoolers cared for by the Children's Hospice "House with a lighthouse", in Kindergarten now only 24 children go. Only 50 students out of 155 study. One young man out of several dozen managed to enter the university. In our country, they do not understand why a terminally ill child needs to study, but hospice children dream of going to school. Artem Komarov is nine years old, but he goes to the second grade. He has a congenital muscular dystrophy- the boy cannot even sit by himself, he has very weak hands. But on an electric wheelchair bought by the hospice, he goes to an ordinary school in the city of Dubna in the Moscow region, the director of which wanted to take the boy, despite a bunch of problems with installing lifts and ramps. The hospice workers helped Artyom make his dream come true and were able to negotiate with the school where Artyom was accepted despite his diagnosis.

Myth three "If it can't be cured, then it can't be helped"

Little Fedya Raspopov was dying quietly in an orphanage. In his medical history - a huge number of diagnoses and the staff did not understand how to care for him. Once upon a time Orphanage invited a visiting hospice service to train nannies. This is how it started amazing story. Successful businesswoman Tatyana Konova responded to a Facebook ad from the hospice to bring Fedya a toy. She fell in love and took him to her, became a foster mother. Unfortunately, the boy cannot be cured. But how striking is the contrast between his life in the orphanage without special care- and at home, with my mother, with the support of the hospice.

Myth four "Hospice is when nothing can be done"

Thirteen-year-old smiling tall handsome man Maxim Bezugly played football with friends. The jump, the other, hung on the gate - they swayed under the weight and fell. The top bar hit the head, breaking the bones of the skull. Doctors said that the injury was incompatible with life, that he would always be on a ventilator. The tragedy divided everything into “ before " and " after ". There was a lot, but now Maxim is at home. Breathe and eat on his own. Every day, parents do something that makes Max feel better.

The head doctor of the hospice, Natalya Savva, talks about how high-quality care prolongs the life of children and returns joy to it.

Myth five "If death is inevitable, nothing can be done"

Mom Elena in December 2016 buried her daughter Pelageya, who was under the care of the hospice. She had an innate genetic disease, she lived nine months in hospitals and intensive care units. The girl's heart stopped. Now Elena admits that during these 9 months only hospice workers were with her. They helped her accept the inevitable.

Life is always stronger than death, even if the smallest and defenseless stand at the line. “ Home ” sure: even if there is almost no strength and faith left - "Time to live"!

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It's been exactly two weeks since I've been living in a hospice.

And this is not a figure of speech, I just live, do not live, do not worry, or something else. I live and breathe full chest, even despite his asthma and slowly recovering bronchitis.

I thank God for what is under New Year I got into this space of love called the First Moscow Hospice.

I am grateful to Vera Vasilievna Millionshchikova, who is undoubtedly a holy woman, because only a holy person with God help could create this.

I am grateful to Nyuta and Diana Vladimirovna for the fact that they are outwardly modest, but in fact very large-scale, serious, thoughtful, constantly doing their job, giving themselves to other people. I am grateful to my wonderful Zoya Vladimirovna (doctor), who sensitively and thoughtfully does her job.

I am grateful to Father Christopher, mother Siluana, Milena. Could I have thought that I would take communion at the Throne like this! I am grateful to the magical Frederica (it is a happiness to know such a person and have the opportunity to communicate).

I am grateful to the nurses and nurses (Dima, you are wonderful!), who not only perform their work smoothly, clearly and quickly, but also fulfill small stupid requests like “can I have a satin ribbon” or “I want a picture with cats”, make surprises , joke, help take care of themselves ("here's coconut oil for your face and hands").

I am grateful to the volunteers, thanks to whom I met Katyushka Borodulkina, made friends with the very beloved dog-therapist Masya, thanks to whom I and my loved ones even had more than one gift and Santa Claus, thanks to which we listened to poems and music, thanks to which I have well-groomed nails and a neat haircut…

You can continue indefinitely, because love knows no boundaries. I am grateful to my friends. It is surprisingly simple how each person from my relatives, friends, acquaintances could open up in this space of love and give me a particle of understanding, sympathy, tenderness, creativity, care. Thank you my good ones! I'm just happy that I have all of you.

When I entered the hospice, it was very difficult. For us, it's the limit. I had intense pain, which could not be stopped even with a combination of very serious drugs. I was suffocating because the weakened body fell ill acute bronchitis, and the drugs gave me asthmatic attacks, which came one after another, I started having cramps from pain and temperature, my legs and arms failed.

First Moscow Hospice

I felt like I had reached the edge of an abyss. I was extremely scared for myself, but even more so for my loved ones. I saw how I frighten those who love me with my terrible deteriorating state of health. It's very scary when close person suffocating, in great pain, and do not know what to do.

Zakharka passed this horror, we tried, but I understood that the New Year for our family could become scary.

For Andrey, for 2-3 such days, the ends of his hair became covered with frost, as it were ... Only 3 days. I am very grateful to my doctor, to the fact that my good, prudent Zoya Vladimirovna, knowing my well-being, anticipated our decision and said that if anything, they were waiting for me in the hospice.

But, I must say, I resisted to the last ("how so, I wanted to make a duck in Czech for Christmas"). This terrible day with asthma and the understanding that I have no right to doom my loved ones to this horror became decisive.

The first day at the hospice was difficult for me. True, I slept for almost a day, since it was the first day when the pain went away completely. First day in many, many weeks. But I woke up in anxiety, feeling that I was completely, completely alone, like a grain of sand in space, that New Year and Christmas were ahead, and I was in a hospice. All this burned.

But I just didn't know. I did not know then that hospice is about life. I have never had such a fabulous New Year, such a wonderful Christmas. I have never had so much love... I have a feeling that God is even closer now. A hospice is a small piece of heaven here on earth.

I am so grateful to God that he gave my loved ones and me such an experience and the opportunity to rest my soul and body after many, many labors.

What follows after all this? Should - live!
Sew sundresses and light dresses from chintz ...
Do you think all this will be worn?
I believe that all this should be sewn!

I will live. Stage 4 is time, sometimes short, sometimes long. The key to all of this is the absence of pain. It shouldn't exist at all.

I have a lot of ideas and plans (I even have a business idea, and I will stick with some of you in the near future, hehe), and I will do everything to the best of my ability and ability ... As God wills. And I will be glad, friends, for your support, your communication, ideas, word, deeds, creativity. Let's create, enjoy and love. This is important and very wonderful.

Well, in general ... Czech duck should be cooked, after all, because it is a culinary masterpiece :))) And I really invite everyone who arrives to it :)

And one more thing... For a considerable number of my friends, the year suddenly began very difficult, I wrote about some of my friends, I didn’t write about some, but they are. I ask you to pray with me. I read the 90th psalm for all those who suffer. I ask you to join too.

And no matter what misfortune touches you, please know that it is at this moment of pain, despair and fear that the Lord is very, very close, and most likely - carries you in his arms. It can be felt. It is worth stopping for a while, shutting up and listening.

is a medical institution, the purpose of which is to care for terminally ill people, to alleviate their suffering in the last days. Such institutions can be state-owned, and, therefore -. For many people, the registration of a sick relative in such an institution becomes the best way out from the situation, because it is not always possible to provide decent care for the dying at home.

Indications for registration in a hospice

There is an opinion that hospice patients are people abandoned by their relatives, and putting a patient in a hospice is the same as dooming him to death in bad conditions. This is not true, high level development of medicine allows to provide maximum comfortable conditions for seriously ill people. Most of the patients in these institutions are people with oncological diseases in the last stages, also here assistance is provided to patients with diseases of cardio-vascular system, neurological pathologies, AIDS and many other incurable diseases.

Note! You can register in a hospice as people in terminal state, and people with a temporary exacerbation of the disease before the onset of remission. Also, people use the services of these institutions to temporarily place a sick relative there for the duration of the trip.

There are two options for enrolling a patient in a hospice:

• outpatient - this requires periodic visits to the clinic;
• inpatient - while the patient constantly stays in the institution.

In the case of outpatient care, the patient is in a medical institution only during the medical procedures and manipulation. This also includes exit medical workers to the patient at home. In more severe cases choose stationary. In this case, the patient needs to stay here around the clock, where he will be under constant control medical workers.

The conditions for admission to the hospice are simple. The indications for registration in such an institution for oncological patients are:

• inoperable cancer (stage 4);
• intense pain syndrome that cannot be dealt with at home;
• unfavorable emotional environment (conflicts in the family), depression, suicide attempts.

Legislative acts regulating the process of registration in a hospice

The procedure for registration and the rules for the provision of palliative care are regulated by the order of the Ministry of Health of the Russian Federation dated April 14, 2015 No. 187n. Its main provisions regarding the issue of registration are indicated in the table.

Patient registration process

If you decide to assign a patient to a hospice, you need to take care of the preparation of documents and be prepared for the fact that there will be no free places in the institution that suits you. In this case, you may be advised to wait or register a relative in another institution. With, as a rule, there are no problems with documenting or finding vacancies.

Required documents

In order for a person to be given a place, you need to collect a small package of documents. This is done to provide evidence that the person really needs palliative care. Also, this documentation is necessary to determine the list of necessary procedures and treatment tactics.

Scroll required documents for registration of a person with oncopathology:

• a document confirming the identity of the patient - a passport;
• referral with a recommendation to a hospice from an oncologist;
• an extract from the medical history that confirms the patient's diagnosis;
• health insurance policy.

Attention! If you are thinking about how to place a cancer patient in a hospice, then first of all you need to take care of a referral from an oncologist. It can be obtained at a simple appointment with the attending physician.

Registration procedure

The sequence of further registration is simple. It is enough to check the availability of places in the institution that suits you. After receiving confirmation of the possibility of registering a patient in this institution, you need to provide said documents upon admission to treatment. Upon admission to the hospital, a person will definitely be examined and examined. Based on these data, as well as extracts from the medical history, the patient is prescribed necessary procedures and mode.

In addition to professional medical care, patients are provided with psychological assistance, the most comfortable psycho-emotional environment is created.

Features of staying in private institutions

The main trend that can be seen when comparing similar public and private establishments is the difference in conditions of detention. This does not mean that the conditions in the state hospice are bad. But private structures have much more to offer. wide range services and service quality. After all, state institutions are equipped within the budget. Differences can also be found in nutrition. In any case, it is compiled by nutritionists and fully complies with the requirements for the diet of patients. But in food, as a rule, more varied and tasty.

The cost of a ward's stay in such an institution depends on the length of stay in the hospice, the number of additional services and the volume of necessary medical procedures. Also, the cost of the stay includes medications that the patient takes.

The unconditional advantage of paid structures is the greater interest of their employees in quality care for the sick. This is not surprising, since the income of this structure directly depends on the number of satisfied patients and their relatives. That is why, if your relative is in a paid hospice, you can not worry about his comfort and state of mind.

Unfortunately, in most government medical institutions the level of service is far from our ideas of ideal care, but this is no reason to doubt the professionalism of the doctors working there. In any of the hospices, everything possible is done to ensure that the last days of each patient's life pass in the most comfortable conditions.

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Hospice is the last refuge for the terminally ill when medicine is already powerless to help. Hospice is a slow dying within the walls of a government institution, saturated with the smells of decay. Hospice is the acceptance of death when it becomes already quite tangible. Approximately with such stereotypes we associate similar institutions. And if you imagine that this hospice is for children?

Therefore, when I was offered to travel to St. Petersburg and get acquainted with the activities of the NGO for pediatric palliative care for minors with serious and incurable diseases, I thought for a while. Due to natural impressionability, it was difficult to decide to see what subconsciously seemed to me as a layman. However, on the other hand, as a doctor, moreover, a father of two children, it was interesting for me to come into contact with this type of medical and social activity, which is not so widespread in Russia, and see everything with my own eyes.

In general, the idea of ​​creating a St. Petersburg children's hospice arose back in 2003, when, through the efforts of the archpriest Alexandra Tkachenko was organized Charitable Foundation "Children's hospice" At the same time, there were simply no such samples, the experience of which could be adopted, in the country. Everything was built on a whim and on enthusiasm. Of course, not without the support of the city authorities and private investors.

Initially, having received a license to conduct medical activities, assistance to seriously ill children was carried out on an outpatient basis, that is, there were mobile teams providing pre-hospital nursing pediatric care, outpatient care, specialized support for pediatric oncology with the necessary socio-psychological component, and by 2010 the first stationary institution in Russia, providing comprehensive palliative care to children - St. Petersburg State Autonomous Healthcare Institution "Hospice (Children's)".

1. This building of the former "Nikolaev Orphanage" (Kurakina Dacha), by the way, is an architectural monument of the 18th century, transferred to the hospice as a room. At the time of its transfer, it was actually in disrepair, and the project for its reconstruction, in addition to strict requirements for the protection of monuments, had to take into account the infrastructure necessary for a medical hospital. Thanks to the incredible efforts of the designers, it was possible to combine all this. So - outside the house seems to be wooden (as expected), but inside is a completely different world.

2. Next to the body surrounded by so loved ones varlamov.ru modern urban high-rise buildings - a well-groomed playground.

3. Let's look inside?

4. What does it look like? School? Polyclinic? Private educational center? Does it look like a hospice in the way that is still rooted in our heads?

5. You can talk platitudes - a feeling of home comfort (it tastes good, but we won’t argue about color here), an atmosphere of confidence and positive emotions. It's not that important. The main thing is not a hospital with white-tiled walls and rusty gurneys along them.

6. On the walls are real paintings (not reproductions), including those made by students of the St. Petersburg State Academic Institute of Painting, Sculpture and Architecture named after I. E. Repin.

7. Meeting with the hospice staff. By the way, this room is also a classroom for developing and creative pursuits, and not only textbook ones, but using music recording, video editing and even creating your own cartoons.

8. Meet - this is the same Alexander Tkachenko. Not a strict, frowning obscurantist archpriest who thinks in dogmas, but quite a lively charming interlocutor with a great sense of humor, able to captivate the interlocutor and completely immersed in this whole story. Not forgetting, however, about the family - and he, for a second, has four sons.

9. Here, for example, is a card index containing data on all the inhabitants of the hospice. For reference: the hospice is designed for 18 beds around the clock, 10 day beds, as well as the organization of work mobile brigades at the rate of 4500 trips per year. At the same time, there are licenses for all necessary activities, including those involving the use of narcotic and strong drugs.

10. Round-the-clock medical control.

11. And this is a creative team, thanks to which new ideas are created for an interesting, and most importantly, as less painful life as possible for children. Precisely life, not existence and survival.

12.

13. One of these notions is the sensory room. Its main purpose is classes with relaxation and polysensory stimulation, the purpose of which is emotional discharge, overcoming protracted crises, and most importantly, establishing a trusting contact between children and specialists. Look - here are light fibers, and a swing-petal, and a board tactile sensations, and a multimedia projector with a screen.

14. An interesting detail of the hospice is a board on which everyone can express their own thoughts to alleviate the suffering of others and receive additional strength for life.

15. Lucky - during a visit to the hospice, there was just a concert for ... I don’t want to say the word "sick" or "patients", let it be - for the inhabitants of this house.

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18.

19.

20. One of the game rooms, divided into several spaces - a development zone motor functions, a zone for the development of intellectual functions (games, puzzles, constructors) and a zone for the development of social skills, where toys for role-playing interaction act as means.

21.

22. In the basement there is even a swimming pool with hydromassage and other bells and whistles. Are we at the hospice? By the way, the designers of the building were against the installation of the pool, but the archpriest managed to convince them. After all, if, for example, a child needs to be baptized, then where to get the "Jordan"? In general, we came to a common denominator.

23. Various "self-propelled carriages" that make life easier for children with limited mobility.

24.

25. Pharmacy and warehouse of medicines.

26. The ground floor of the hospice is completely devoted to the staff and is more technical. However, even here there is a design, perhaps controversial from an artistic point of view, but certainly not giving the feeling of being in some kind of morgue.

27. Behind these doors, for example, are refrigeration units where food is stored.

28. Although ... The morgue is here too. Well, not the morgue, of course. This is just a room where a family says goodbye to a dead child. It's called the sad room. Here is a gurney covered with disposable linen, as well as a candle and an icon, which, of course, can be removed if the family's religion requires it.

29. There is also a rack with children's toys and a shelf with medicines that the child's parents may need.

30. When someone in the hospice dies, this candle burns at the reception for several days.

31. We rise to the second floor. It is the main one, since it is here that children's wards are located.

32. Nursing post.

33. And even a separate room for the cat.

34. Parents spend almost all the time with very small inhabitants.

35.

36. And this boy is already quite independent. He is erudite beyond his years, reasonable, it is quite possible to communicate with him as with an adult. Many have noticed that severe illness make children older and wiser much earlier.

37. We will not disclose names, surnames and diagnoses.

38. By the way, this miniature Cologne Cathedral was assembled by a young designer so carefully that Alexander Tkachenko is simply delighted. In any case, the local residents need such attention like air or that same nutrient solution.

39. Next to the treatment room.

40. And this is a block intensive care for the heaviest children who require round-the-clock supervision and support, where, in addition to functional beds, there are sofas for parents. An interesting and probably symbolic detail - the ceilings are decorated in the form of a clear sky with balloons flying up.

41. Well, illness is illness, and dinner, as they say, is on schedule.

42. What do we have on the menu today?

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44. And as many as twelve wall clocks on the wall. Also a symbol?

45. And on the uppermost attic floor there is a house church in honor of St. Luke (Voyno-Yasenetsky), where services are held weekly. It is open at any time and there are candles completely free.

Hospice is called medical institution in which terminally ill patients are assisted in last stage diseases. The word itself comes from the Latin "hospitum", meaning hospitality. So from the 6th century, places of rest for travelers were called. The first hospices were along the roads along which Christian pilgrims walked. Tired and exhausted people stopped in such establishments.

At present, incurable patients are surviving in these institutions. official medicine can no longer help. In the CIS countries, cancer patients are usually placed in hospices. These institutions are extremely wary, and sometimes even squeamish attitude. Meanwhile, they are very popular in the West. It's time to debunk the main myths about hospices and understand how society really needs them.

Hospice appeared in Russia recently. In Moscow, a specialized institution of this kind for cancer patients appeared back in 1903. The initiative came from the famous oncologist, Professor Levshin. He has been raising funds through charity for several years. A four-story building for 65 people appeared on Pogodinskaya Street. For that time, it was an advanced institution, preparations with radium were tested here. But in the 1920s, the institution lost its original functions, turning into a research clinic. In our time, the first hospice opened in St. Petersburg in 1994.

Getting a patient into a hospice means his imminent death. Do not take this institution as a house of death. Palliative care improves the quality of life. It's about about the elimination of pain syndrome, proper nursing care, the support of a psychologist. A stay in a hospice is not a preparation for death, but an attempt to make life as worthy as possible until its very end.

Only cancer patients are admitted to the hospice. Access to palliative care is essential for anyone with a life-limiting chronic disease. International studies have proven that 70% of patients with such problems can improve their quality of life through palliative care. This includes people with heart, kidney, lung disease, dementia, or kidney failure. Even patients with chronic diseases find support here, learn to deal with their problem on a daily basis, stay active and feel better.

In the hospice, pain syndromes are reduced only with the help of drugs. Palliative care includes whole complex measures. People are taught to manage pain through spiritual and psychosocial care. The very term "all-consuming pain", which is used in hospices, includes suffering not only physical, but also psychological, spiritual, social. This general stress must be removed. In palliative care there is a place for narcotic painkillers, but the course is not limited to them alone.

Palliative care is provided only in the hospice. There is a hospice outreach service that provides palliative care at home. Doctors and nurses can teach relatives how to properly care for the sick, instill in them the philosophy of the hospice. The fact that a person can no longer be saved does not mean that he cannot be helped.

Hospices are for the elderly. Hospices, along with a palliative care program, are available to patients of all ages. I do not want to think that children can suffer from incurable diseases. In practice, a significant portion of hospice care is for babies who have fatal or life-limiting illnesses. Palliative care programs themselves should ideally be prepared for patients of all ages. There are some shelters that are designed specifically for children.

All those in need receive palliative care. The World Alliance of Palliative Care Organizations shows that only one in ten patients receive the required support. And these are the average figures for the world, in Russia it is even worse. Currently, only 40% of patients receive palliative care in Moscow hospices. Without full-fledged such support, the system of medical care in the country cannot be considered complete. The terminally ill should be able to get hospice care from specialists.

People live in hospices for several days. It seems that in hospices, patients manage to live only a few days, the bill is best case goes for weeks. But the largest insurance companies in the world offer hospice services for six months. If the patient managed to save his life, then he can stay here and further, or return here at any time. Sometimes the departure of a team of professionals works wonders. Here they see patients as people, and not a serious diagnosis. As a result good care allows many to live longer than doctors predicted.

Getting into a hospice means giving up the fight. Hospice patients never give up. Employees continue to fight for the life of the patient, offering the family to do the same. Care focuses on hope. They are trying to convince people that they will not feel pain, that they will soon be able to go outside, see their grandchildren at the weekend, and celebrate the upcoming anniversary. You should always hope for recovery, but at the same time you need to prepare for the probable future.

Hospice hastens the death of a patient. Many are afraid of going to a hospice, believing that they will end their lives there faster than at home. In fact, numerous studies have shown that people with the same diagnosis live longer in a hospice, in contrast to those who refuse such a service. The facility gives you the opportunity to live more last days and also better quality.

The hospice requires a receipt for the refusal of resuscitation. Some hospices require such a receipt, while others do not. To get a place in a hospice, such paper is not at all mandatory. In fact, the document says that in the event of a cardiac arrest, the patient refuses to try to start the organ using electric current. The fact is that this is fraught with fractures of the ribs. Such paper allows you to give permission to leave a person without torturing the staff and yourself. But the signature can always be revoked. The purpose of the hospice is to help the person, not to demand something from him.

It is better to die at home than in a hospice, hospital, or nursing home. Hospice is not a place, but a support from a team of professionals. They work with people wherever they are. Hospices can be located in homes, apartments, trailers, homeless shelters, nursing homes, and nursing homes. The hospice should be in a place that the patient himself considers his home.

Hospices stop giving medicines. Often people even in their last days take drugs from a long list. Refusal of some of them is really able to increase well-being or improve appetite. If there is a diagnosis that leaves a few months of life, then there is no point in lowering cholesterol or treating osteoporosis. While in the hospice, you can eat as many eggs or ice cream as you want! Why not indulge in whipped cream with strawberries? In any case, doctors will give recommendations on which medications no longer make sense to take, but the final decision remains with the patient himself.

Hospice makes patients addicted to drugs. In very small doses, drugs can be effective in relieving pain syndromes and improved breathing. Medical team has extensive experience in the use of narcotic drugs, giving them in such a volume that the patient can feel better and maintain his former lifestyle. Doses are given in small doses so that they do not lead to a blackout and do not lead to addiction. Those who are afraid to take drugs may ask the nurse to be with them after the first dose, assessing their comfort.

Hospice is expensive. In the West, hospice services are covered by private insurance companies. Many shelters have their own funds to cover expenses or are looking for ways to raise funds.

Getting into a hospice means that it will no longer be possible to communicate with the attending physician. Hospice doctors work in close cooperation with treating doctors. Together they will create the best treatment plan, optimal for the patient. You just need to inform the hospice that consultations with your doctor will continue.

Hospice means complete failure from your own decisions. The hospice is built around a man-made plan. The patient seems to be riding in a transport, choosing his own path. Everything around helps to make the car run smoother.

The hospice provides round the clock care. At the hospice, a team is available 24/7 to provide assistance and medical service. But the team never takes responsibility for care and promises to provide permanent care responding immediately to all problems. Not all hospices are able to constantly monitor their patients, this should be taken into account.

All hospices are the same, whether they are commercial projects or charities. Each hospice must provide certain services, but the paths often differ. Just as there are many business models for running a restaurant, there are also options for providing care in such establishments. And sometimes it is important for families to know whether they are dealing with a commercial enterprise or a charitable organization. Keeping a patient in a hospice can become very expensive in the absence of insurance.