Palliative care in Germany (2015)

When compared with other countries, Germany’s provision of palliative care still leaves much to be desired; sustained commitment towards research in palliative care would be an important step towards addressing such shortcomings. The aim of palliative care is to achieve or maintain the best possible quality of life for patients, their families and relatives in the face of life-threatening, incurable conditions. ‘Palliative care’ is used here as a generic term for any activities involving such individuals. The prevention and relief of suffering are key priorities. A prerequisite of this is the early recognition and accurate recording of all impairments, symptoms and areas of conflict at all physical, mental, social and spiritual levels. In recent years, public discussion about the topic of life and death has gained in importance. In surveys, 54 percent of respondents reported having contemplated their own mortality. Thirty-nine percent claimed that the topic of life and death was an important or very important concern for members of their immediate circle. The most common causes of death in Germany are cardiovascular disease and cancer, which account for more than 500,000 fatalities every year. Most of these afflicted people spend their final days suffering from physical symptoms such as pain or dyspnoea, and both they and their families can also be burdened with psychosocial or spiritual problems. Patients with other severe diseases, such as neurological disorders (Parkinson’s disease, dementia, multiple sclerosis, etc.) and lung diseases, as well as frail, older patients with a range of medical conditions, also require palliative care. Children and adolescents need special care depending on their developmental stage, on the prevailing spectrum of diseases and on their family circumstances. There is also conjecture about the efficiency of palliative care, since health care research in this area is still in its early days, and there is a substantial need for studies focused on the field of palliative medicine. This statement will make recommendations about what has to be done in the light of both the need to catch up and the perceptible additional demands the future will bring. These recommendations take into account the irrefutable entitlement we have to the best possible quality of life, and the specific care required by critically and terminally ill patients.