FOCUS Online Mr, Maier, you have to do every day with people who are terminally ill. What are the differences in the dying process of Covid-19 patients of the other Dying?
Bernd Oliver Maier: Many people suffer, for example, under a severe cancer, to die at the end of a pneumonia. At Covid-19 is no different. But here the dying process is like in time lapse. The people suffer in a dramatic Tempo of air and difficulty in breathing that we know of no other disease with her.
For us, as a palliative physician, this means that we need to emphasize the rescue, medical side of our work stronger. We need to react faster than usual and make sure that we have the events not running behind.Die Covid-19: Against the shortness of breath medication help, the fear of death remains, St. Josefs-Hospital Wiesbaden Dr. Bernd Oliver Maier is the reigning Vice-President of the German society for palliative medicine, and since 2013, chief physician at the St. Josefs-Hospital in Wiesbaden.
FOCUS Online : Is the death due to the Virus is a painful?
Maier , of Course, can experience pain, as in many of the dying processes at Covid-19. However, we have made the experience that this Virus is primarily the shortness of breath. Fortunately, we can urge with the use of special drugs air hunger of the patient, so the feeling to suffocate, back. We would not be able to do, would be connected to the dying process, in fact, with enormous Suffering.
a second factor is added, which has made the process of dying at Covid-19, especially in the initial phase, so extraordinary, and sometimes tragic: the fear. People who are treated on a palliative ward, know that you are terminally ill and will die. Many close with this fate of your peace.
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But see the images from Bergamo and Spain in the media, has changed the Situation. The idea that now, under the Italian conditions, in Isolation and away from their families and loved ones die, Palliative-treated patients, quite simply, panic and fear of death. Many who were actually infected and the Virus instead of actually fateful disease died, felt the cynical said Pointe as a Conclusion, as a doubling of their life tragedy.prohibition: "The conciliatory farewell is smashed to pieces on the Isolationstür"
FOCUS Online : How they have stood the people in this Situation?
Maier We have done what we do as palliative care practitioners, We have tried to alleviate the Suffering of the people as far as possible – but only under massively difficult conditions. Against the mixture of fear and air hunger, the patient suffered from, helped on the one hand, the above-mentioned drugs. On the other hand, we have tried, more than ever, the people a sense of security, a good lifted to give one. Not always succeeded in this. Because people dying by pulling strength from the assistance and the emotional ties with family and relatives.
FOCUS Online : All of this has been lacking in the Phase of the lock downs. How very visit bans, and contact constraints have impacted on the life and death of the Palliative patient?
Maier In many cases dying people and their families to arrange with each other. They make a mutual promise, to make the end of the journey of life together, and forgiving. This conciliatory farewell is shattered in Corona-times, however, the Isolationstür.
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of Course, understood" there was in the acute case of death as well as in clinics derogations from the ban on visitors. We have wrestled in every single case to make the hospice as close and human as possible, to find a Balance between prohibition and our safety promise as a palliative physician to the Dying and their relatives. But we carry a piece of the overall responsibility for, and will not be able to inform us of the applicable rules. The sad consequence is that many people have died in the past few months alone. You and your family felt helpless and left alone. This has left deep wounds.
FOCUS Online : there Is a case that you found particularly moving?
Maier There are several. I remember, for example, an older man who was on the brink of death, as he had to be moved as Covid-19-suspected cases to the isolation ward. He had only a few hours, and his wife wanted to say goodbye. But not because at that time the test processes so sophisticated, it could take up to 48 hours until the result of the Covid-Tests existed.
I telephoned and telephoned, to get as quickly as possible for safety and to be able to let the wife to her husband. Without Success. As the test result was available, had died of the man. His wife could not say goodbye to. The Bitterest thing of all: The Test was negative. This has highlighted for me personally the whole Perversion of this Situation. And it was certainly not an isolated case.
FOCUS Online Why have you decided to support people in the dying process?
Maier Because I believe that it is a very important task is not to forget that the Die is in medicine a natural part of life. It would be wrong to let the people in the Moment in which we can no longer be in the sense of a "repair medicine" worked, alone. It is a very intense and meaningful work that can not give back very much, if one focuses on the result of Survival – provided the framework to allow it to be his own claim.
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FOCUS Online you Could be in the past few months, your claim as a Palliative care physician to meet?
Maier My experiences in the pandemic have me respond made it very clear what thin ice we are on the road, how difficult the medical apparatus creates, in this exceptional situation. We are missing so much from the entire image, for example, our elderly and vulnerable patients. My personal low point was to see that dying people are cared for in this Situation worse. Which is repugnant to my claim, just the most vulnerable and help the most needy group of patients. And Yes, that hurt me.
FOCUS Online : Due to your experience you felt compelled to write an open letter to the Federal Minister of health, Jens Spahn. They demand more outpatient hospice. Why is it especially important now that people can die at home? the
Maier : Dying people wish for a dignified end-of-life. It is only understandable that such may be more likely to take place in your own home in the family circle than in a hospital bed or in isolation. The Suffering of Palliative patients is to relieve the home as well as in the hospital. It is not a question of location, but of the Expertise.
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The Corona-crisis has demonstrated that outpatient Palliative care is still no structural requirements. The focus was clearly on saving as many lives as possible. It has operated beds, a massive upgrade of ventilators, intensive care capacity and the hospital. That was the way it should be. But all those are forgotten, where Survival is no longer an Option. The struggle for the Rescue of life one has to forget a piece of the Dying.
FOCUS Online What changes in the palliative care they desire?
Maier : I expect a political Signal that the pandemic and the fact that they have so many social bonds are shattered, the importance of an outpatient palliative medicine has finally recognized. Not only working rescue medical chains are important, even the acute palliative medical. We therefore need financial support to viable Palliative to build up networks of physicians, and house physicians, so that the scenes of the lonely dying, as I and many of my colleagues have experienced it, repeat.
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