How long can we live without a doctor

Medicine at the end of life - caring support

What can medicine achieve at the end of life?

At the end of life it is no longer about extending life at any cost. Rather, it should be carefully found out what helps you and what doesn't. That is the job of P.alliative care.

Many different professional groups such as nurses, doctors, social workers, pastors work together here. You cannot work miracles. But they are there for you and can often effectively alleviate symptoms. Volunteer hospice workers support this work by holding talks or keeping night watch.

Support in the dying phase

At the end of life, physical and mental strength can increasingly decrease. The dying lose interest in eating, drinking and contact. It's normal and part of dying.

Nutrition: It can be difficult to endure when the dying person stops eating or drinking. But artificial feeding means an unnecessary burden for many dying people. Hunger and thirst should only be quenched when the dying person expresses this.

Pain: Many fear unbearable pain at the end of their life. However, pain can usually be relieved effectively. It can rarely be that conventional pain treatment is no longer sufficient. If you wish, the dose of pain medication can then be greatly increased.

Unbearable complaints: In order to alleviate the most severe suffering, there are also drugs that suppress consciousness. This is only very rarely really necessary. But it can be a relief to know that this possibility exists.

Refraining from life-prolonging treatment: In the last phase of life, for many, it is no longer about fighting a disease at any cost. It is becoming more important to design the remaining lifetime as far as possible without being impaired by medical measures. Side effects of treatments, frequent visits to the doctor or hospital stays are becoming more and more stressful. Some no longer want to accept that. You have the right to refuse any treatment. If you wish, the treating physicians can also refrain from or end life-sustaining measures such as artificial respiration. It is important that you do this early on in a Living will establish.

Power of attorney and living will

In a power of attorney and living will, you can set out in advance how you would like to know how the last phase of your life will be shaped.

With a power of attorney, you entrust a person you trust to take care of certain matters in the event that you can no longer be approached or made decisions yourself. This includes, among other things, making legally binding declarations. The health care proxy is only valid in the original. You can revoke it at any time.

With an advance directive, you determine how you would like to be treated by a doctor or nurse in certain situations. You can also specify when resuscitation should take place or when life support devices should be switched off.

On the website of the Federal Ministry of Justice and Consumer Protection you will find information on care law as well as sample forms and text modules on living wills, power of attorney and care directives: www.bmjv.de.

At home, hospital or hospice

If you want to spend the last time of your life at home, the decisive factor is whether you have a caring relative or a caring relative and whether your living situation allows it. Doctors, usually your family doctor, and nursing teams come to your home. If hospital treatment is required, you can be cared for in a normal ward or a palliative ward.

If you feel better, you will be sent home or sent to a hospice. A hospice is a place where the seriously ill and the dying are cared for when hospital treatment is not necessary but home care is not possible.

What you can do yourself: take precautions, take others into your confidence

  • Everyone can get into the position of no longer being able to decide for themselves. In this case, consider whether you would like to take precautionary measures with a living will and a power of attorney.

  • Talk to people who are close to you about your values ​​and wishes. The more they know about you, the more likely they will be able to make decisions on your behalf if you are no longer able to do so yourself.

  • It can also be helpful to speak to your general practitioner early on about how you envision your final lifetime.

  • The following applies in every phase of life: You decide for yourself which measures you want to take on. You can also decline this or end it prematurely, for example artificial nutrition. Be open about this.

  • You don't have to brave complaints. Tell them if you are not feeling well and get help.

  • You can get help with social or legal questions, for example, from social services, advice centers or self-help organizations.

  • A Germany-wide directory for hospices can be found here: www.wegweiser-hospiz-palliativmedizin.de.

April 2017, published by the German Medical Association and the National Association of Statutory Health Insurance Physicians