Krakowiak Piotr
Uniwersytet Mikołaja Kopernika w Toruniu, Torun 87-100, Poland.
Palliat Care Soc Pract. 2020 Sep 29;14:2632352420958001. doi: 10.1177/2632352420958001. eCollection 2020.
The growth of life expectancy in Central Eastern Europe and increase in the number of older people in that region are the consequences of changes in the 1990s period, connected to transition from the communism into a market economy. Central Eastern Europe is already facing consequences of fast ageing and insufficient development of state health care and social services. Those result in gaps in the provision of end-of-life care and overburden of family caregivers. This essay addresses gaps in end-of-life care, showing the development of hospice-palliative care on one side, and highlighting main problems with long-term care on the other. There is scarce support for informal caregivers and lack of cooperation between health and social care. End-of-life care is over medicalized in hospice-palliative care and hardly existing in long-term care. Dying is more a social than medical event, and as such, it should be cared for by compassionate communities, encouraging cooperation of professionals with family caregivers and society. Unfortunately, to date, there is no adequate cooperation in social dimension of end-of-life care in most of Central Eastern Europe. The social dimension of end-of-life care has to be recognized and empowered with the health promoting palliative care and introduction of compassionate communities in Central Eastern Europe.
中东欧地区预期寿命的增长以及该地区老年人数量的增加是20世纪90年代变化的结果，这些变化与从共产主义向市场经济的转型有关。中东欧已经面临着快速老龄化以及国家医疗保健和社会服务发展不足的后果。这些导致了临终关怀服务的缺口以及家庭护理人员的负担过重。本文探讨了临终关怀服务的缺口，一方面展示了临终关怀与姑息治疗的发展，另一方面突出了长期护理的主要问题。对非正式护理人员的支持匮乏，且医疗保健与社会护理之间缺乏合作。在临终关怀与姑息治疗中，临终关怀过度医学化，而在长期护理中几乎不存在。死亡更多是一个社会事件而非医疗事件，因此，应由富有同情心的社区来照料，鼓励专业人员与家庭护理人员及社会合作。不幸的是，迄今为止，中东欧大部分地区在临终关怀服务的社会层面上没有充分的合作。中东欧必须认识到临终关怀服务的社会层面，并通过促进健康的姑息治疗以及引入富有同情心的社区来增强这一层面。
