Well-attended lecture in the district office of Landsberg about dying with dignity

Created: 05/23/2022, 02:00 p.m

By: Ulrike Osman

Professor Veronika Schraut informs about a self-determined dignified death © Ulrike Osman

Landsberg - It's a topic that affects everyone at some point and that is still often pushed aside - the end of life.

In this respect, not only Erich Püttner, chairman of the Landsberg hospice and palliative care association, was amazed at the fully occupied meeting room of the district office on this summery May afternoon.

As part of the district culture days, Veronika Schraut, professor of nursing at the Kempten University of Applied Sciences, gave a lecture entitled: “Self-determined to the end.

How do we want and are we allowed to die?” The 40-year-old knows the subject from both a practical and theoretical point of view.

After graduating from high school, she trained as a geriatric nurse – actually in order to then study medicine.

But she saw so much in her day-to-day work that called for change that she instead turned to nursing management and nursing science to "get into people's heads."

In the meantime, she has found that even that is not enough - that not only thinking, but also the framework conditions have to be changed.

And so Schraut is now also politically active,

60 percent of people would like to die at home - that was the result of a representative survey in 2016. Among the caring relatives, as many as 76 percent would like to take care of their family member at home until the end.

Dying in a hospice is far behind, at 16 and 8 percent respectively.

And in the hospital or nursing home, only a small minority would like to end their lives.

In practice, however, it is almost the other way around - far more people die in hospitals and homes than would be desirable according to the survey.

"The topic is strongly institutionalized," says Schraut.

"Dying in the family is no longer common."

So how to counter that?

First of all, it is important to realize that people are also autonomous when their ability to self-determination is limited.

Living wills are a way of knowing that your wishes have been fulfilled, even if you can no longer express them.

However, caution is required here and advice on drafting is urgently required.

Because, according to Schraut, even the living will is no guarantee that everything will happen the way the person concerned wants it to happen.

The topic of dying for people with dementia is different again. Schraut interviewed relatives and carers of deceased dementia patients as part of a qualitative study.

It turned out that these also balance their lives in a certain way and that dying becomes difficult and tormenting as long as final matters are not settled.

That is why sensitive support from a caregiver is all the more important for a dignified death.

At best, she is able to perceive the needs of the patient in a differentiated way.

Greater mental clarity sometimes occurs just before death.

An increase in the stress hormone cortisol in the brain could be responsible for this.

So-called "oral refusal" often occurs - liquid and food are refused.

It is frightening that, according to a study from 2005, almost two-thirds of dementia patients with moderate or high levels of suffering die - this, although palliative medicine now actually enables complete freedom from pain.

But people with dementia can no longer communicate their pain verbally - instead, the suffering can manifest itself as increasing confusion, agitation or apathetic withdrawal.

That's why Schraut calls for more scientific and practical information about support options.