Our palliative care unit (PCU) belongs to the Karl-Hansen-Klinik in Bad Lippspringe, located in the eastern part of the state of North-Rhine-Westfalia, close to the city of Paderborn. The PCU has been established in 1998 and is an integral part of the Paderborner Palliativnetz e.V. (est. 2007). Overall, 35 people work on the PCU and around 150 doctors, nurses and other health care professionals belong to our network.
Our PCU is a department of the Karl-Hansen-Klinik, a community hospital with a large intensive care and weaning unit, an ENT department, and departments of internal medicine, infectiology, pain and sleep medicine, early rehabilitation and psychiatry. It is a 10-bed-in-patient-unit and accepts adult patients with all kinds of end-stage disease (tumor and non-tumor). There is a close cooperation with the SAPV-system (Specialized Ambulatory Palliative Care) to which family doctors, specialists, general and palliative care nurses and other health care professionals belong. More than 300 patients will be treated annually on the PCU, the average stay of duration is 12 days. More than 1400 patients are enclosed by the SAPV-system per year.
One clinical specialty and on-going scientific project is our effort to estimate life-time-expectancy as precisely as possible, so that the medical indication for our mission of optimal symptom control on the one hand and optimal use of the remaining resources can be balanced as well as possible in the individual situation. Heart rate variability, hand grip strength as well as muscle mass are being explored in conjunction with other established parameters for that purpose. The second specialty of our unit is the in-depth exploration of the individual quality of life by tools such as the SEI-QoL. We believe that comprehensive interviews and the exploration of bibliographical as well as psychological and cultural aspects in addition to religious beliefs and character-associated aspects form the crucial basis for optimal symptom control, especially because symptoms are perceived and expressed in a very personal and individual way.
Palliative and Supportive Care
There is a long established low threshold cooperation of our PCU with the ambulatory palliative care network in the community of Paderborn-Höxter. Interdisciplinary cooperation is the key component by which individual symptom burden can be relieved at home, in a nursing home, in the hospice or at our PCU. On the basis of the estimated life expectancy, communication efforts aim at not only to perceive what a patient knows to his situation but also to have a good understanding of the meaning of the current status and future perspective. Medical and non-medical approaches as well as personal care go side by side. No enteral or parenteral nutrition will be enforced if the cachexia-syndrome is present or the patient has no appetite; palliative sedation will be offered according to the EAPC-guidelines after a team consensus has been built. Relaxation techniques will be offered to patients and relatives as well as art and aroma therapy.