Cover news reporter Ning Zhi
"The husband walked peacefully and with dignity, thanks!"
"My father is a terminal stomach cancer, and he sleeps well here at night and rests well during the day, thank you!"
"Here, we face death head-on and complete the will of our lives."
……
In order to provide more end-stage patients with all-round life cycle care, Chengdu Fifth People's Hospital is making every effort to explore the hospice passport care model of the top three hospitals. On Last month's "World Day of Tranquility and Palliative Care", the reporter came to the hospice ward of the Geriatric Department of the Fifth People's Hospital of Chengdu to learn how it makes life leave with dignity.
Hospital Geriatrics Ward
Patients are here to the end of their lives
Spacious ward, painted with large trees, birds, blue sky, white clouds... In the hospice ward of the Geriatric Department of the Fifth People's Hospital of Chengdu, Ms. Wang's husband walked peacefully.
On September 17, 2019, her husband was diagnosed with advanced pancreatic cancer and had no chance of surgery. After being hospitalized for a week and discharged from the hospital, he controlled his condition through traditional Chinese medicine, but due to the accelerated deterioration of his condition in the later stage, his husband was in pain, unable to eat or drink, unable to sleep all night, and fidgeting.
"Watching my husband's pain and unspeakable pain, my heart was like a knife but I was helpless." Ms. Wang said. Fortunately, on December 5, 2019, her husband was admitted to the 143 beds of the hospice ward of the Department of Geriatrics by the Fifth People's Hospital of Chengdu.
In the hospice ward, the medical staff minimized ms. Wang's husband's painful symptoms, improved his quality of life during his survival, and relieved the physical and mental stress of patients and families.
Here, in 2020, Ms. Wang's husband calmly walked to the end of his life. Watching her husband leave peacefully, Ms. Wang especially thanked the medical staff and emotionally wrote a letter of thanks.
Palliative care puts people in the face of death
The hardest thing most difficult for most people to face is death, but death is the natural process of life. Zhou Lihua, director of the Department of Geriatrics at the Fifth People's Hospital of Chengdu, said: "If a patient has advanced cancer and enters the countdown to life, in our country, many family members are unwilling to tell the patient what disease he really has, so that some patients do not know what disease they have until they die." ”
Therefore, hospice care will first make patients and families face death. "When a patient comes to our hospice ward, the first condition is to let him know he has the disease. If you don't know, a lot of treatment can't be done, and psychological counseling is difficult to complete. ”
Zhou Lihua introduced that according to the definition of the World Health Organization, palliative care is to provide patients with services to alleviate pain and other painful symptoms, the purpose is neither to accelerate the death process, nor to delay the death process, while actively controlling painful symptoms, alleviating the psychological and mental pain of patients and their families. It treats death as a normal life process, provides patients with a full range of services, makes them as active as possible before the end of life, and provides help to families to get patients through the process from birth to death.
Who is suitable for hospice treatment? Zhou Lihua said that the first is terminal disease patients, the expected survival time is < 6 months (including patients with advanced tumors, terminal respiratory failure or heart failure and other diseases), and the second is the patients and their families who are willing and cooperate with the management of the hospice unit.
What hobbies patients have, but also carefully ask clearly
Zhou Lihua told reporters that the content of palliative care services mainly includes symptom control, comfortable nursing, psychological counseling, grief counseling and social support. "After the patient enters hospice care, the doctor will assess the survival of the patient, and then carry out the necessary relevant auxiliary examinations and symptom assessment, and set the corresponding management plan according to the symptoms, such as we will use drug treatment, rehabilitation physiotherapy, aromatherapy, etc., to alleviate the pain of the patient's body."
In terms of patient spirit, the medical members of the hospice team also pay great attention. "We will find out how the patient wants to go, whether he wants to transfer to the intensive care unit, whether he is willing to intubate, whether he agrees to CPR, what he wants to do most, what he likes to do the most, which family member he wants to accompany, and what else needs to be explained to the family... Try to satisfy the patient's wishes to alleviate their suffering. In addition, medical members will also use small stories to provide them with psychological counseling, so that they can calmly accept the loss of life and say goodbye to their families.
It is reported that the hospice care team of Chengdu Fifth People's Hospital is composed of multidisciplinary members, including geriatric medical staff, as well as mental, psychological, nutrition, social workers and other patients to manage patients. Wang Zhong, director of the Clinical Nutrition Department of the hospital, introduced: "For patients with palliative care, we will focus on humanistic care, so that they can live a more pleasant life, the quality of life is higher, and the survival value is better." In terms of nutrition, it will first be adjusted according to their tastes and preferences, first let them eat it, and then consider what to choose to eat. ”
In the geriatrics department of the hospital, the elderly are outdoors.
It became the second batch of pilot units of hospice care in Chengdu
By the end of 2019, China's elderly population over the age of 60 reached 253 million, accounting for 18.1% of the total population. In stark contrast, there are insufficient numbers of geriatric medical institutions, rehabilitation institutions, nursing institutions, and hospice care institutions across the country.
Chengdu has been an aging city for nearly 20 years, so Chengdu is also one of the pilot cities for hospice care identified by the National Health Commission. In order to actively respond to the Chengdu Municipal Health Commission's "Notice on the Declaration of Hospice Care Pilot Units", in 2019, Chengdu Fifth People's Hospital combined with the actual situation of the regional medical center of the top three hospitals, set up a multidisciplinary hospice care team in the department of geriatrics, began to explore the hospice care service model, and became the second batch of pilot units of hospice care in Chengdu.
It is gratifying that palliative care is gradually being understood and accepted by the Chinese people. "Most patients with terminal illness have a long hospital stay and a lot of money, many hospitals are reluctant to accept them, and patients will be very painful at this time, so they will choose palliative care." Zhou Lihua said.
"When a person walks alone, he will be very lonely, and the family will continue to say goodbye to the patient in his ear, because people's hearing is the last to be lost." Zhou Lihua told reporters that she had met a patient, the heartbeat had stopped, but the family still kept saying goodbye to him, and miraculously, the patient's tears flowed out in an instant.
For the work of palliative care, Zhou Lihua also has a lot of emotional aspects, "Seeing the patient gone, our hearts are still very uncomfortable. Sometimes we ourselves are counseled and learn to adjust ourselves. However, it is our constant mission to let life leave with dignity and give patients warmth and love, and we hope that when every patient dies, it can be as quiet and beautiful as autumn leaves. ”
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