An unusual space in a hospital building 150km south of Belgrade. The walls are a gentle shade of pink, spotlessly clean corridors, a nice atmosphere. At the end of a long hall way on the right there is a space for a future living room and a modern kitchen. All patient rooms have two beds and a bathroom. Kind and caring medical staff dedicated to seriously ill patients. This is the image of the Department of Palliative Care in the General Hospital in Cuprija. This Department was renovated six months ago with the financial support of the Ministry of Health. Equipment for the units was purchased through the project “Development of Palliative Care Services in Serbia,” funded by the European Union (EU), and employees were trained and gained new knowledge and skills to deal with palliative care patients.
“We can make it easier for a dying patient to die if we help him bear the rest of his life, by not letting him suffer”.
Dr Kübler-Ross E
The Hospital in Cuprija is more than 120 years old. It receives some 300,000 patients from the Pomoravlje region annually, and often patients come from other parts of Serbia. Since February2014, the newly opened palliative care unit admits patients with terminal illnesses who receive complete medical care 24hours a day.
Quiet music can be heard in the unit. The doors of the unit on the second floor, which can be accessed by two elevators, are always open to patient families and caregivers. One doctor, Dr. Vladan Milosevic, Head of the unit and seven nurses are responsible for the patients. Some nurses have worked for more than 20 years in the General Hospital in Cuprija, such as the Head nurse Vojislava Stanojevic. She says that her motivation to work in the unit comes from personal experience with a terminally ill family member. “I know what these people are going through,” she says.
Young Dr. Zvezdan Djordjevic volunteers here and is learning new skills. He wants to work in palliative care in the future and will specialise in this field. With the support of the EU project Development of Palliative Care Services in Serbia, palliative medicine was introduced as a course in Medical Faculties in Serbia.
Global standards
The Palliative Care Unit in Cuprija’s General Hospital is located in the same building that houses the dialysis ward. The Palliative Care Unit comprises 400 square meters of renovated space which do not resemble a hospital in any way. Apart from the inscription on the door “patient’s room”, it is difficult to believe that patients with terminal illnesses are being looked after here. Dr. Milosevic says that the Unit will soon have nine beds (currently there are four), and that the Unit was renovated and equipped according to international standards for palliative care.
“Our palliative care unit opened in late 2013 and since February of this year we have taken care of 50 patients with severe illnesses, malignant and other diseases. Doctors and nurses are looking after patients together with the hospital psychologist and a social worker,” explains Dr. Milosevic. It means a lot to the families of the patients that are being looked after. Patient stay in the unit allows family members to take a break after many years of caring for loved ones without any support. “People finally rest when they leave their dearest with us, and when they come to the department, it is obvious they have gathered the strength to go on,” said one nurse.
Families are very pleased with the accommodation and care provided by the staff. In the guest book they do not hide their satisfaction and gratitude to the staff.
Some individuals continue to visit the Department even after the death of their family member. “An old lady, whose husband died, brought us his left-over medication. She wanted other patients to have some use from them,” said nurse Vojislava.
| Living room
The Department will soon be equipped with a living room in which family members will be able to stay during visits to their loved ones. The staff hopes that they will manage to furnish it from donations. When family members come from distant places, they will be able to rest and sleep in the unit if they wish. At the Hospital in Cuprija, palliative care is organized according to international and European standards. |
Ivan Kojic from Cuprija comes daily to visit his father who was admitted to this unit in poor health. “There is no institution in which my father could be admitted, and as soon as we learned of this department, we brought him. Here he was given great care and attention, and it was a great help to me and my mother. Truly exceptional people work here” said a grateful Ivan. “I am aware that we cannot influence father’s illness, but at least we can to improve his quality of life,” he added.
There is a specific atmosphere in the Department. The rooms are unlike in classical hospitals, they exclusively accommodate two patients. There is a family atmosphere, which is very important for all patients who come here.
“A patient’s smile is what we cherish the most, and that cannot be measured with anything. A grandmother who was unable to eat and speak was admitted recently. Now she eats and talks and everyone is surprised by her recovery. We provide great support to patients and families and we are not just a service for dying patients. It is hard to work here, but it is humanity what matters, “said nurse Vojislava.
| Home atmosphere
The conditions in the Unit a requite specific. “It nourishes a home atmosphere because it is very important that patients feel comfortable. This main objective is to provide comprehensive palliative care, control of complex symptoms like nausea, vomiting, loss of appetite, pain control, but also to provide respite care,” said Dr. Milosevic. Respite care is an important component of the care provided by PCUs for a defined, limited time (up to a maximum of 2 weeks) for a palliative care patient being cared for at home (subject to bed availability). Family members or other primary caregivers caring for a palliative care patient at home may suffer from the continuous burden of care. Therefore respite care for previously registered palliative care patients, may offer these patients and their caregivers a planned or unplanned break, and enable them to continue to care for the patient at home. |
Dr. Milosevic, president of the recently established Coordinating Body for Palliative Care within the Health Council of the Municipality of Cuprija, believes that the establishment of such a body will contribute to the development and further advancement of palliative care and improve coordination between services which provide palliative care. The team includes representatives of local government, General Hospital, Health Centre Cuprija, Institute of Public Health, Centre for Social Work, Gerontology Centre of Jagodina, municipal Red Cross, the Serbian Orthodox Church and other religious community representatives, civil society organizations and Pomoravlje branch of the National Health Insurance Fund.
