End of life: a different perspective on palliative care

The palliative care units (USP) are still too often seen as "death houses", both by the public and health professionals, lamented specialists present at the press conference presenting a symposium organized Paris, on "Palliative Care: the death of the units is she afraid of?".
From a purely statistical point of view, according to the figures mentioned in the press presentation of the conference, if 10-20% of patients with a disease in advanced or terminal accommodated in the USP return home or are directed to more appropriate structures, 80-90% of them die in the care unit in a variable delay.

But beyond the numbers, USP are real "places to live, even if death is present," said Dr. Daniel Hérouville, department head at home medical Jeanne Garnier (Paris, fifteenth arrondissement).

The evidence gathered through a survey conducted among people whose relatives were hospitalized at this Parisian palliative care between 2003 and 2005 show that, without denying the proximity of death, patients, carers, caregivers and volunteers accompanying view that life is possible in these structures.

Thus, the analysis of 960 questionnaires (a total of 2,177 letters sent by the Commission on relations with users, a return rate of 44%) showed that 65% of respondents to the survey believe that a USP as home medical Jeanne Garnier is a living, while only 9% of participants rather see it as a hospice.

Among other evidence, this type of structure is described as an institution "for a good life out of" the same way that maternity is designed "for a good entry into life." A similar description states that "it is advisable to sleep well for 'a moment of calm' and calming before going to bed and fall asleep after a day of life. This is somewhat the same applied to the entire life, "reads the summary of the survey results.

Moreover, the vast majority (95%) of survey participants felt that it was necessary to increase the number of USP in France.

"In such a structure, the patient, near death, finds a name, a life, dignity. Teams who provide care and support must be professional, efficient, combining extreme competence with humanity, listening, availability, and honesty. Life in a USP requires a simulation of appeasement, openness and dialogue between all environmental quality and dignity to a situation of extreme pain and unknown ", the authors summarize the conclusion of this review.