Most want to die at home or in the hospice



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Most Germans prefer to die at home

The older people get, the more intensely they deal with the subject of death. Many have a clear idea of ​​where and how their lives should end best. On behalf of the German Hospice and Palliative Association (DHPV), the research group elections conducted a representative population survey under the heading "Dying in Germany - Knowledge and Attitudes to Dying".

The results of the DHPV population survey show that many Germans (58 percent) believe that society is too little concerned with the subject of dying and death. In most cases, anyone who deals with their own death wishes to die at home. But death in the hospice is also a desirable way of leaving life for just under a fifth of those surveyed. Almost no respondents spoke in favor of death in the hospital or nursing home. In fact, however, only 25 percent of people die at home, five percent in the hospice and a full 70 percent in nursing homes and clinics. Here there is a considerable divergence between the population's perception of death and the actual circumstances when dying.

Over 1,000 people interviewed on the subject of dying and death The survey by the German Hospice and Palliative Association makes it clear that in many people (39 percent of those surveyed) dying and death play a large to very important role in their personal environment. The majority (83 percent) have already faced the death of a loved one. More than half of the population (54 percent) has “often” or “now and then” thought about their own death, according to the DHPV. While dealing with one's own death tends to increase in older age, 48 percent of young people between the ages of 18 and 29 also think about their own death. The "Research Group Telephone Fields" surveyed a total of 1,044 Germans aged 18 and over. "We were amazed at how openly and readily people spoke about this topic," explained Matthias Jung, managing director of the research group Wahlen. A total of 66 percent of those surveyed indicated that they would prefer to die at home, 18 percent preferred to die in a facility specifically for the care of seriously ill and dying people (hospice).

High level of trust in personal networks The frequently expressed wish for death within one's own four walls also shows the high level of trust the population has in personal networks, according to the DHPV. According to the results of the representative survey, almost all respondents (90 percent) assume that their relatives, friends and neighbors take care of them in the event of illness. Single people were also 76 percent convinced that people from their personal environment would take care of them in the event of illness. In the case of long-term care, "72 percent of all respondents and 66 percent of those aged 60 and older assume that someone from family, friends or neighborhood will take care of them," said the DHPV. However, according to the experts, seriously ill and dying people actually need a high level of care and support that can usually not be provided solely by the personal environment of those affected. For example, the personal network "must be provided with a well-developed supply and care network that accompanies people in their last phase of life in close exchange with family, friends and neighborhood," said the DHPV.

Pain therapies at home more promising? On behalf of the DHPV, the researchers also determined what experiences the respondents have had to date with pain therapy for people close to them. “72 percent of those surveyed rated the pain therapy of a person close to them at home as good; in comparison, only 49 percent perceived pain therapy in the hospital as good, ”said the DHPV. This clear difference in the assessment cannot be explained at the drug level. Rather, he "points out that in addition to physical symptoms, completely different needs also play a role at the end of life, which can be expressed in pain and pain sensation," reports the DHPV. Therefore, not only medical and nursing care is required, but also spiritual and psychosocial care, security and closeness can be crucial for the success of pain therapy. A hospital in which the work processes are (must) be standardized cannot generally take this claim into account. The former Federal Minister of Justice and patron of the DHPV, Prof. Dr. Herta Däubler-Gmelin, summarized: "Accompanied, cared for, without pain" is the hoped-for idea of ​​most people's own death.

General practitioner as a contact person looking for hospice and palliative care facilities. The CEO of the German Hospice and Palliative Care Association, Dr. Birgit Weihrauch explained, "The survey results provide a wide range of information about the knowledge and attitudes of the population about dying and death - important bases for us to be able to react more specifically to the requirements." A special role comes in the care of the patients Patients in their last phase of life to general practitioners, explained the deputy chairman of the DHPV, Dr. Erich Rösch, When looking for a palliative or hospice facility, most patients would turn to their family doctor. The patient should therefore be able to choose the right care offer for the patient from the complex care structures. Here it is "urgent that general practitioners themselves are well informed about the hospice and palliative services so that they can give their patients competent advice about hospice and palliative care and the possibility of hospice and palliative care in their environment," the message said of the DHPV. The association would therefore also like to work with the legislator to give doctors room to care for people at the end of their lives and to ensure that doctors can also spend the necessary time.

Many older people have already signed an advance directive How many people deal specifically with the subject of dying and death is also evident from the number of advance directives. As many as 26 percent of those surveyed have already drawn up a living will and 43 percent have already given it serious consideration, reports the DHPV. "Both when drafting the living will and when seriously dealing with it," according to the DHPV, "age plays an important role." Accordingly, the proportion among people over the age of 60 is significantly higher than among younger people. 42 percent of those over the age of 60 have already made a corresponding decision and another 43 percent have already seriously considered it. "These results are also important in view of the fact that dealing with these questions also promotes the debate and dialogue in our society about life and death," said the DHPV. (fp)

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