What is the purpose of living and dying

How we deal with deathLife and death in the hospice

An inanimate side street in Berlin Neuk├Âlln. The oldest hospice in Berlin can be reached by elevator. Up to fifteen patients live on the fifth floor. Anyone who moves in here knows that there is a high probability that they will only have a short time to live. There is a clear condition for admission to the hospice: the patient needs a medical certificate with the prognosis that he or she is terminally ill and will soon die. People come here who the doctors say are "out of therapy".

Quality of life instead of life extension

Full-time and voluntary dying attendants, palliative medicine specialists and pastors accompany these people through the last phase of their lives. The goal here is no longer to extend life, but to spend the last few days and weeks as painlessly and with dignity as possible. 120 to 150 people die here every year.

Lively everyday life

"What surprised me particularly when I started here: I always imagined hospices to be dark and fearful," says Michael Liedgens. "I was completely amazed at how bright it is here - and how much people laugh here." He has been involved in voluntary work for years.

Michael Liedgens, volunteer in the hospice (Jakob Schmidt)

He sits at the reception desk, takes calls and greets visitors. Liedgens points to a large, transparent chest. Thousands of paper stars lie in it. Each one has a name. "When the resident arrives here, a star is hung on the front door of his room," he says. When a patient dies, his star is placed in the chest in memory of him.

Review of life

A star like this also hangs on Helga Kellmann's door. Like the vast majority here, she has terminal cancer. She is happy about the visit and the opportunity to look back: "I have to say, there was a good life from childhood to retirement! I wouldn't do much differently either," she laughs.

Individual care

Because she can hardly walk because of the pain, Ms. Kellmann has to spend a lot of time in the room. Caregiver Philipp Freund brings her lunch right to bed. He is one of four nurses who share the morning shift. The hospice, he says, is not a place where people philosophize about death from morning to night. And death is as individual as the life that people have lived before. "What people regret are more the things they haven't done than the things they have done," he says. "If I had dared to change jobs, I would have separated from my husband and my family. I just have one life. And the shorter the time, the clearer it becomes."

Chest with stars in memory of the deceased (Jakob Schmidt)

Most of them would like to die at home

Many residents have had a long odyssey through hospitals before they come here to the hospice. They tell of bad experiences with medical staff who often lacked the time to really respond to people. Most of them appreciate the warm and humane atmosphere, which makes the holistic approach here in the hospice all the more. Still, most residents would like to spend the end of their lives at home. In a familiar environment, supported by your own relatives. Almost 60 percent of all Germans share this wish, according to a representative survey by the German Hospice and Palliative Association. The reality, however, is in great contrast. The vast majority of people in hospitals still die.

A story of displacement

Prof. Winfried Hardinghaus is the chairman of the German Hospice and Palliative Association and has headed a palliative ward in Berlin for many years. A department in the hospital that specializes in the treatment and care of terminally ill people. The palliative and hospice movement is a reaction to a society that has made death taboo, he says.

Medication instead of care

After the traumatic experiences from two world wars, there was hardly any room for discussions about how to deal with one's own finitude in the affluent society that followed: "Our belief in drugs, the belief in technical progress in medicine was immense, which made it easier, to suppress death. We didn't expect that we could die, "says Hardinghaus. The result: Death often took place under undignified conditions: "I myself have seen how the dying in the hospital were really transferred to the bathroom to die."

Positive development

This taboo, says Hardinghaus, has still not completely disappeared from society. But a lot has already changed for the better. This is also ensured by innovative concepts: For example, for outpatient or semi-inpatient hospice services, where the terminally ill can spend the day and relatives can bring them home in the evening. "We have not yet reached our goal," says Hardinghaus, "of course."

(Repetition from 02.15.2019)