During a discussion titled Rights for Dignified Death organised on Wednesday, the 22nd of March, Riga Eastern Clinical University Hospital (RAKUS) Palliative Care Unit’s manager Vilnis Sosārs stressed – hospice service should become a fundamental part of medicine.
Sosārs mentioned that during the Covid-19 pandemic people did not sign up for examinations. Lack of early examination resulted in people turning to medical workers with already progressing health problems, complaining about various health problems. He said palliative care is not a stable process – it varies, because a person’s conditions can improve or get worse to the point of the patient being unable to even sit up.
Sosārs said the emphasis on the quality of life could happen only if the palliative care system is developed. This requires training, change of attitude and practical approach, as well as improvement of the level of education and empathy of the general public. At the same time, he said he is
ashamed that Latvia does not have a developed hospice care even though the state programme has been ready for many years.
According to Sosārs, without a good team, palliative care or hospice care is not possible. Structural integrity and cooperation between various teams also play an important part. This includes the Ministry of Health, Ministry of Welfare and lawyers. Patients require constant care. Workers have to communicate with patients and their relatives.
«If we can develop structures that have proven their worth, it will only add to the overall value. RAKUS is only one institution, it cannot fill all of the people that require care in Riga. A hospice will be an initiative for future structures that will be formed in Latvia, becoming a fundamental part of medicine,» said the head of Palliative Care Unit.
Hospice is the final stage of palliative care, when the predicted life expectancy does not exceed six months. Hospice LV co-founder Ilze Zosule explained that this care applies to all people – newborns, children of all ages, as well as adults. As for the reasons why this sector remains undeveloped in Latvia, he said it is possible
historical stigma is to blame.
She said during the Soviet occupation suffering was honoured, and only what was acquired through hard work and suffering was respected, whereas the value of living was devalued.
The other reason for this situation, according to Zosule, is the overall level of healthcare in the country. In a time when other medical sectors have many unresolved problems, it would not be ethical to focus on the development of hospice services. Zosule stressed that hospice care should develop alongside with other medical sectors to ensure services are equally accessible.
Additionally, until now Latvia had no organisation to bring up this topic. Zosule said when a patient dies, his or her problems die with them, but this is not the case in reality. Patients stay in hospice care for an average of three to four weeks, and their relatives have other problems to deal with.
President of Malta George Vella’s wife Miriam Vella, President of Latvia Egils Levits’ wife Andra Levite and University of Latvia vice-rector Valdis Segliņš at Rights for dignified death forum. Photo: Evija Trifanova/LETAAndra Levite, the wife of Latvian President Egils Levits, mentioned that often relatives of patients often require help not only when the patient passes away but also after the patient passes away. Fewer and fewer families live together with their elderly parents and see them pass away at home. There are many reasons for that.
For example, different generations no longer live together. Modern work conditions require mobility. Marriages fall apart. Social media promote the cult of youth. Additionally, the global statistical data indicates the majority of terminally ill people are women, Levite says.
«During the pandemic women had to school their children in addition to everyday duties. Even now there are risks for us to burn out. Women can do anything, but it would be great if they didn’t have to do it alone,» said the president’s wife.
Miriam Vella, wife of the President of Malta George Vella, said hospice in Malta is a non-government organisation founded 34 years ago in order to provide free palliative care to terminally ill people.
Every year Malta hospice’s multi-disciplinary team provides aid to 1 300 patients and their families.
Vella added it helps prevent unnecessary use of hospital services.
Andra Levite also said Latvia needs institutions and people who understand the situation and are emphatic. She believes palliative care requires a doctor that helps if there is a need for help and leaves patients in peace if there is no immediate problem. For example, a dying person does not require regular tests. There is also no need to wake patients at six o’clock in the morning to check their body temperature.
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