Final days full of life - Hospice stories | DW Documentary

Key Concepts

• Hospice Care: Comprehensive care focused on providing comfort and quality of life for individuals with life-limiting illnesses.
• Palliative Care: Relief of the symptoms and stresses of serious illness, aiming to improve quality of life for both the patient and their family.
• End-of-Life Care: Specific care provided during the final stages of life, focusing on comfort, dignity, and emotional support.
• Wish Fulfillment: Providing opportunities for hospice residents to experience desired activities or destinations, enhancing their quality of life.
• Taboo of Death: The societal discomfort and avoidance of discussing death and dying.
• Importance of Human Connection: The critical role of relationships and resolving conflicts in the dying process.

The Importance of Dignified End-of-Life Care: Insights from German Hospices

This documentary explores the compassionate world of hospice care in Germany, focusing on two facilities: the South City Hospital Hospice in Rostock and Bentof Castle Hospice near Bentof. It highlights the dedication of staff and volunteers to providing dignified, fulfilling end-of-life experiences for residents, challenging the societal taboo surrounding death and emphasizing the importance of living fully until the very end.

I. Daily Life and Philosophy of Care at South City Hospital Hospice (Rostock)

The South City Hospital Hospice prioritizes maximizing the quality of life for its ten residents. The daily routine, described as a “marathon,” is individualized, respecting each resident’s rhythm. Residents are not woken before they are ready, and their needs – physical, emotional, and social – are paramount.

• Holistic Approach: Care begins with simple acts like oral hygiene (“When your mouth’s fresh, everything else follows”) and progresses to include physical therapy (demonstrated with a “one, two, three, push” exercise), social interaction, and emotional support.
• Emphasis on Autonomy: Residents are encouraged to participate in their own care as much as possible (“do it yourself, with me”).
• Multidisciplinary Team: The hospice is directly connected to the hospital, ensuring 24/7 access to medical expertise, with a team of three anesthetists rotating in four-week shifts. Dr. Yan Patrick Hnner, the medical director, emphasizes the value of having time to address not just physical symptoms, but also unresolved emotional conflicts that can hinder acceptance of death.
• Financial Aspects: 95% of costs are covered by health insurance, with the remaining 5% funded by donations.
• Notable Quote: “Tears are part of it and laughter is central, of course, but the needs of the residents are always our priority.”

II. Addressing the Taboo of Death and the Role of Film

The documentary underscores the societal avoidance of death as a topic. The film crew’s project, “I’m Dying. Are you coming?”, aims to break down this taboo.

• The Film’s Narrative: The film follows a young mother in hospice care fighting for more time with her son and her ex-partner.
• Director’s Motivation: Director Beyamin Kama, drawing on his experience as a nursing assistant at a hospice, used a diary to inform the film’s characters and situations, aiming for authenticity.
• Bentof Castle Hospice’s Support: Vangu, the founder of Bentof Castle Hospice, readily agreed to the film’s production, believing it would raise awareness and alleviate fear surrounding death. His wife’s death from cancer in 2006 motivated him to create a dignified space for end-of-life care.
• Resident Involvement: Residents at Bentof Castle, like Kula Ka, actively participated in the film, even taking on small roles.
• Data Point: The film crew spent three weeks filming at Bentof Castle Hospice.

III. Bentof Castle Hospice: A Family-Run Model

Bentof Castle Hospice, a family-run facility, currently cares for 16 residents. It emphasizes creating a home-like environment and providing individualized care.

• Resident Perspective: Kula Ka, a resident with two rare autoimmune diseases, finds the film crew a welcome distraction and feels prepared for death, advocating for acceptance and appreciation of each day.
• Notable Quote: “To maintain a certain quality of life, I’d recommend accepting it. But still, even if you have accepted it and feel good about yourself, there are of course days when you say, 'Why did this happen to me?' That's just how it is. You struggle and simply want it over and done with. But that's changed for me. I enjoy each day now, take things as they come, and appreciate every special moment.”
• Focus on Quality of Life: Activities are tailored to individual preferences, and the hospice actively seeks to fulfill residents’ wishes.

IV. The Wishmobile: Fulfilling Last Desires

The “Wishmobile” program, supported by donations, exemplifies the commitment to enhancing residents’ quality of life. Volunteers accompany residents on outings to fulfill their final wishes.

• Examples of Wishes: Trips to zoos (Hagenbeck Zoo in Hamburg was a recent destination for Hansban Schultz and his wife Monica), visits to the sea, attending concerts, or simply returning home.
• Emergency Preparedness: The Wishmobile is equipped to handle medical emergencies, with a retired firefighter and a medical technical assistant on board.
• Data Point: Seven Wishmobile tours were completed last year, a record number.
• Volunteer Impact: Volunteers like Uva and Sandra find deep fulfillment in helping residents experience joy and closure.

V. The Emotional Toll and Rewards of Hospice Work

The documentary acknowledges the emotional challenges faced by hospice staff and volunteers.

• Emotional Impact: Powell, a nurse at the South City Hospital Hospice, describes the profound impact of caring for young patients and witnessing the grief of their families. He lights a candle in the lounge to signal a death, allowing the team to collectively acknowledge the loss.
• Long-Term Dedication: Powell knew he wanted to work in hospice care since age 12, inspired by the compassionate care his grandparents received.
• Volunteer Motivation: Paul Bukholz volunteers after her husband received care at the hospice, and retired teacher two book finds fulfillment in giving back.
• Notable Quote: “You never know how much time you have, so you should use it well and carefully.” – Benjamin Kama, Director.

Conclusion

The documentary powerfully illustrates that hospice care is not simply about preparing for death, but about embracing life until the very end. By prioritizing comfort, dignity, emotional support, and the fulfillment of personal wishes, these German hospices provide a model for compassionate end-of-life care, challenging societal norms and advocating for a more open and accepting conversation about death and dying. The dedication of staff, volunteers, and the support of the community are essential in creating environments where individuals can live their final days with meaning and peace.