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The Warsaw Voice » Other » September 16, 2009
The Lower Silesia Voice
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Space for Living
September 16, 2009   
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Zbigniew Żylicz, MD, PhD, director of the Dove House Hospice in Hull, England,talks to Barbara Deręgowska about care for the terminally ill.

Your patients suffer from incurable illnesses. How can they be helped in the final stages of their lives?
We try to make people understand and accept the fact that death, like birth, is part of life and nothing can change that. We work to make sure that our patients don't have to suffer in their final moments, that they have time to say good-bye to their nearest and dearest, to become reconciled to their fate. Finally, we are fighting for a place in modern medicine, for a more humane approach to people and their pain.

How can one help terminally ill patients so that they do not feel pain?
Pain has many dimensions. With our patients, this is never just one sick nerve or organ or just one kind of physical pain. With our patients, pain is always present in the context of the human being as a whole: mental and social and other factors combine to cause a person to suffer. It's a paradox, but combating physical pain alone can exacerbate other symptoms. That's why an integrated approach to the problem is needed, starting from the fact that we accept that someone is dying. That's extremely important. Once we accept this, our decisions will be different, dictated by other rigors, other considerations.

In principle, our aim is to alleviate physical pain while maintaining the patient in the best physical and mental condition. Every painkiller has its side effects, most often affecting the patient's cognitive capacity.

What does your hospice do to improve the quality of life for patients in the final stages of their lives?
We try to help our patients get into the depths of their lives. We deal with advanced illnesses, not only terminal cases. Many patients are admitted in critical condition. About half of them improve and, being in better condition, can go home. Because it's only there that they feel comfortable and can arrange various private matters. Doctors have to be alert, critical, pay attention. Very seldom, but it does happen that the diagnosis is wrong, that accepting approaching death is not the right approach, that we have to fight. Every patient is a separate story. A patient is not his or her illness. We don't treat pancreatic cancer, but a suffering person. Patients have their names and their histories. We try to get to know them better, understand them.

The beds in our hospice are placed in spacious four-person rooms; we also have four single rooms. Apart from this, there are rooms for physiotherapy, light therapy, music therapy, for exercising and games. Our patients don't only play chess and cards. Those who can walk can meet in the well equipped lounge, go out on the terrace or into the garden. The chapel is open all the time, its interior designed so that people of different denominations can feel at home. We also have a smoking room because we don't want to cause patients extra stress by forcing them to quit smoking. The hospice gets only a quarter of its funds from government subsidies. The rest is provided by a registered charity based on donations, charity work and volunteers. We run our own stores, hold sponsored walks, music festivals and raffles involving various companies.

We have excellent social workers, including our chaplain. They work with great sensitivity and dedication. We treat patients by all working as a team. Once a week we have a meeting and think about how best to deal with specific problems. And, most importantly, we do our best to make our patients' wishes and dreams come true.

Dr. Zbigniew Żylicz, 54, married with five children. He graduated from the Faculty of Medicine at the University of Medical Sciences in Gdańsk in 1979. In 1988, he obtained an PhD in clinical pharmacology from the University of Nijmegen in the Netherlands. He became a consultant internist at the same university in 1990. He became a consultant medical oncologist at the University of Groningen, the Netherlands, in 1992. In 1992-2004, he was the medical director of the first hospice in the Netherlands. In 2001-2005, he worked as an associate professor at the Collegium Medicum in Bydgoszcz. As of 2005, he has been the medical director of the Dove House Hospice in Hull, England. He is a specialist in palliative medicine, a teacher of many doctors and nurses. Traveling all over the world, he gives lectures on a new approach to combating pain. He has written five books, including textbooks, and 130 scientific papers. In 2006, for his exceptional efforts in establishing and running hospices, he received the Officer's Cross of the Order of Orange-Nassau from Queen Beatrix of the Netherlands.
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