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Dealing of palliative care in home environment from perspective of patients and family members
 BRODCOVÁ, Petra
Bachelor thesis is dealing with topic of home palliative care. The aim of the thesis is to find out how the patients and their accompanying family members are coping with providing care in the home environment. Because majority of incurable ill persons are willing to die at home with their close family members then the topic of palliative care is becoming a hot discussed topic. In general, there is being settled new centres where the patients in terminal stage of life can receive palliative care. In contrary to Czech Republic in foreign countries are the hospice services and palliative care more spread and anchored in the medical system. Nevertheless, there is aim of our Czech doctors, palliative care associations and many other organizations to contribute and set up the conditions for palliative care development. The care which should be available for all sick persons and which should offer the good quality and dignified dying to all patients. In the Bachelor thesis were set up three research questions with the focus to answer the aim of the thesis. The first research question is dealing to describe the scope of barriers which are common in the home palliative care. The second research question consists of the analysis of the needs of ill person and their accompanying family members. The third research question is targeting to describe the process of home palliative care. The research was done by method of qualified survey with the help of semi-structured interview and method of observation. The research itself was performed among eleven persons. There were five nurses employed in the home palliative care. Further on there were three patients in terminal stage of life and their three accompanying family members. The answers from interviewees were processed with the method of "pencil-paper. "The method of observation was used at the sick interviewees in the terminal stage of life where was detected what are the relations in the family, what is the patient's status and which household conditions can allow the home palliative care. Those results were continuously recorded into the Observation sheet. Based on the obtained results it is possible to mention that home palliative care can be provided in the stable and cooperating family who lives in the flat or house suitable for providing all necessary supporting equipment to the ill person and which lives in the accessible distance for the employees of home palliative care. During the interviews with the ill persons in the terminal stage of life and their accompanying person were not detected any barriers which would not allow to provide palliative care in the home environment. From the point of view of nurses are the major barriers not cooperating families, difficult communication with families and the lack of physical strength on the side of accompanying persons. Holistic view on the ill and the accompanying person allow to nurses satisfy respondent needs in all aspects, that means they care about biological-psychological-social and spiritual areas. By the listed respondents' nurses provide mainly psychological support, in the biological area they cure about the pain of ill persons. Considering the results from research survey the home palliative care has enormous success and the increasing palliative care is becoming a standard in the treatment about the patient. The results from Bachelor thesis can serve in the future in the education of next nurses.
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