Mogućnosti poboljšanja kvalitete života u terminalnom stadiju neizlječive bolesti razvojem suvremenih oblika palijativne skrbi na području Bjelovarsko-bilogorske županije
The Possibilities for Improving Quality of Life in the Terminal Stage of Incurable Diseases by Developing Up-To-Date Forms of Palliative Care in the Bjelovar-Bilogora County

Summary/Abstract: In the area of the Bjelovar-Bilogora County, 350–450 patients die annually suffering from malignant diseases. One fourth of these patients die at the Bjelovar General Hospital, while the others die either at their own home or at a nursing home. Their residence and way of dying on any of these locations is usually not in compliance with the up-to-date knowledge and skills of the health care profession with regard to fulfilling the complex needs in palliative care, which is the only form of care to be provided in the terminal stage of a disease. As a result of the overall awareness of this fact, the Ministry of Health initiated in 2012 the drafting of the strategy for the development of palliative care in the Republic of Croatia. Thereby, a basis for planning staffing, and the introduction of organisational forms and capacities necessary for a comprehensive and high-quality health care for patients in the terminal stage of incurable disease was created. According to the experience of economically developed European countries, the optimal organisation of palliative care includes home care supervised by multidisciplinary teams educated in provision of visits at patient's home as well as to provide outpatient services for the symptom control in palliative care. In inpatient institutions, primarily hospitals, it is the most rational to organise a palliative care unit which can include a day hospice and a palliative care ward. Depending on the financial power of a community, a hospice as a special palliative care institution may also be established. Hospices may be publicly owned, privately owned, owned by religious communities or by philanthropic trusts. The Bjelovar-Bilogora County already disposes of facilities at the secondary health-care level that may be used for the purposes of providing palliative care. However, for this, as well as for the organisation of palliative care at any other level, trained staff is needed, so that investing in staff training presents a priority task. It is essential for improvement of existing level of palliative care in the aim to improve the quality of life for patients as well as to preserve professional staff employment within the health care system.

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