Kapunk tárva, a szívünk még inkább! Mr. Miklós Lukacs nurse director, hospice expert e-mail: [email protected], Web: www.irgalmasokpecs.hu, www.hospice.hu HOSPICE-PALLIATIVE CARE IN HUNGARY Palliative Healthcare Symposium 18.-21. April. 2013.
Jan 01, 2016
Kapunk tárva,a szívünk még inkább!
Mr. Miklós Lukacsnurse director, hospice expert
e-mail: [email protected],
Web: www.irgalmasokpecs.hu, www.hospice.hu
HOSPICE-PALLIATIVE CARE IN HUNGARY
Palliative Healthcare Symposium18.-21. April. 2013.
Kapunk tárva,a szívünk még inkább!
EVERY CRISIS IS A NEW SITUATION
4 „C”
► CONFLICT
► COHESION
► COMMUNICATION
► COMPLIANCE
Kapunk tárva,a szívünk még inkább!
P
E
P
S
I
•Physical•Emotional•Psychological•Spiritual•Inter Personal
Calman (1993)
WHY HOSPICE HOME CARE?
The reduction of costly hospital care The social care needs of humános conditions.
Kapunk tárva,a szívünk még inkább!
Statistical data in Hungary
►Number of population: 10.076.581
►Number of death:128.795
►Cancer death:32.670
Kapunk tárva,a szívünk még inkább!
The most frequent cancer illnesses
►Respiratory system cancers
►Digestive tract cancers
►Prostata cancer
►Breast cancer
►Head-neck cancer
Kapunk tárva,a szívünk még inkább!
Palliative care milestones•1991 - Hungarian hospice movement is founded.•1994/95 - Hospice teams with the help of the Soros Foundation.•1997 - Hungarian Health Law declares the human right of palliative care and defines hospice care.•2002 - Palliative care guideline is launched •2004 - Hospice minimum standards which gives official licences and special financing.•2004 - Hospice financing system by the National Health Insurance Service
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THE HOSPICE SERVICES- 84 hospice organisation- 10 Inpatient Palliative Care Units, 162 beds- 69 Home care teams- 2 Nursing home 15 beds- 3 Consultant teams in Hospitals - 1 Hospice House, 10 beds
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COVERAGE OF THE HOSPICE CARE ORGANIZATION
Hospice organization = umbrella organization Hungarian Hospice Palliative Association www.hospice.hu
Complex servicesBudapestMiskolcPecs
inpatient unit, hospice home care, hospital mobile team, day care centre, pain outpatient clinic, psycho-oncological outpatient clinic, telephone mental health service, bereavement service, education centre
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PATIENTS IN HOSPICE CARE
HOSPICE CARE► Patients: 7019
► Inpatient Palliative Care Units: 2355
► Hospice home care: 4086
► Day centres: 449
► 94% of patients have a cancer diagnosis
► Averige care time: 36 day
► Using beds: 79,6%
Kapunk tárva,a szívünk még inkább!
EDUCATION PROGRAM FOR NURSE AND DOCTOR/theoretical and practical training/
NURSE PROGRAM
► basic course - 40 hours
► advanced course - 40 hours
► 1200 hours hospice nurse and coordinator training program to the certificate exam
DOCTOR PROGRAM► basic course - 40 hours
► advanced course - 40 hours
► practical course – 80 hours in hospice unit
► Palliative course for the medical students(Budapest, Pécs)
► 2013. october – palliative license exam
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STAFF IN HOSPICE CARE(multidisciplinary team) 1507 PERSONS
► 60,1% doctor► 69,7% nurse► 62,7% physiotherapists► 72,9% psychologists and
mental health experts► 73,7% volunteers► 31,4% priests► 41,8% social workers► 59,8% dietists► 69,5% coordinators► 44,4% occupational therapists► 78,5% bereavement
counsellors
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ACCESS TO IN HOSPICE-PALLIATIVE CARE
HOSPICE CARE
► physician recommends
► GP’s ordered
► patient's or family consent, compliance
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FINANCE IN HOSPICE-PALLIATIVE CARE
HOSPICE HOME CARE
► insurance pays for a day home care: 3840 HUF – 14 EUR – visit day, insurance-funded day vizit - 150 day
► insurance pays for a day hospice unit care: 9520 HUF – 34 EUR – care day
HOSPICE UNIT
The benefit to the patient free
Kapunk tárva,a szívünk még inkább!
TASKS IN HOSPICE CAREHOSPICE CARE
► nursing tasks
► physiotherapist tasks
► symptom management
► Dieticians tasks
► Social task
► Spiritual tasks
► Psychical tasks
► Physician tasks
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AGREE?
► The serious illness of a serious impact on the family, care team► Flexible rate adaptive► The hospice palliative care in a family care► Bridge care► The family assessment begins when the patient is in the care► All members working in hospice care with the family► All members are family expert► Families and the patients are different► We work in different cultures► Assess the family environment► Family dynamics