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Golla, Heidrun; Fink, Gereon R.; Rolke, Roman; Lorenzl, Stefan; Ebke, Markus; Montag, Thomas; Gold, Ralf; Nelles, Gereon; Eggers, Carsten und Voltz, Raymond (2017): Palliativmedizinische Versorgung neurologischer Patienten. In: Aktuelle Neurologie, Bd. 44, Nr. 6: S. 388-399

Volltext auf 'Open Access LMU' nicht verfügbar.

Abstract

Although patients with incurable neurological diseases suffer from a variety of distressing symptoms and may die from their neurological condition and associated complications, palliative and hospice care for these patients to date remains rare. First estimates envisage that on average 10% of all patients suffering from a neurological disease need palliative and hospice care. However, within German neurology departments, only few physicians (on average 1.3/department) and nurses (on average 2.2./department) are specialized in palliative and hospice care and only about 3% of patients cared for in palliative or hospice care structures suffer from neurological diseases (in contrast to patients suffering from oncological diseases, approximately 80%). Responsible for this rather low number is a just gradual increase in the awareness of palliative and hospice care needs for neurological patients and a currently predominant supply of oncological patients in palliative and hospice care structures which are primarily aimed at these patients. In line with this is that the special aspects of neurological patients are currently not adequately addressed in the palliative training curricula of health care professionals. Rather, patients with advanced neurological conditions are medically cared for by general practitioners and by the existing inpatient and outpatient neurological structures, which may also offer sub-specialty services. Consequently, adequate care for severely affected neurological patients becomes difficult as soon as these patients are hardly able to visit these structures since home-based specialist treatment is currently only limitedly carried out and financed. Novel yet to date rare approaches, mostly of international origin, suggest that these patients may benefit from specialized home based services, combining neurological and palliative care expertise. At present, data that characterize the situation of neuro-palliative care in Germany remain scarce. In addition to the already known supply gaps (e.g. low rate of neurologists trained in palliative medicine as well as of nurses working in neurology trained in palliative care, lacking consideration of the specific (care) needs of neurological patients in general and specialized palliative and hospice care structures, hardly available home-based outpatient specialists) research is a prerequisite to identify current gaps in palliative care of neurological patients in more detail and how these might be overcome in the future.

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