1. IMPLEMENTATION OF HOSPICE – PALLIATIVE CARE IN HUNGARY Hungarian Hospice Foundation Dr. Katalin Muszbek

3. Attitude to palliative care in the 80s Cancer is equal with death and dying 80C% of people with advanced cancer died in hospitals in very poor conditions Palliative care, pain and symptom control was not acknowledged

4. Attitude to palliative care in the 80s Education of medical personnel was based on active treatments Psychologıcal and spiritual aspects. communication skills, breaking bad news was not include into medical curriculum Death and dying belonged to the taboos

5. SUFFERING PATIENTS… Patients mainly die in hospitals  lonely  depressed  suffering of pain and other symptoms

6. Palliative care should be adapted for quality end of life are in Hungary

7. Implementation of Palliative care in Hungary Elements: 1. Clinical activities: home care services and palliative inpatient units 2. Training programs for professionals and volunteers 3. Public education for changing public beliefs to death and dying

8. Palliative care activities -Home care -Palliative Inpatient unit -Day centre -Pain clinic -Palliative mobile team -Hospice House -Bereavement support group

9. SERVICE DEVELOPMENT IN HUNGARY 2008 49 organisations 12 inpatient unit (176 beds) 30 home care team 4 nursing home (34 beds) 2 day care centers 4 palliative care support team Resource: Hungarian Hospice Palliative Association

10. HOSPICE-PALLIATIVE CARE IN HUNGARY IN 2008 No. of patients in 2008: 4 527 in total: 30 468 Average time of care : inpatient: 28,6 days home care: 48,4 days Resource: Hungarian Hospice Palliative Association

11. HOSPICE-PALLIATIVE CARE IN HUNGARY IN 2008 Resource: Hungarian Hospice Palliative Association Number of hospice professionals in Hungary 19952008 Physician22103 Nurse74509 Physiotherapist873 Psychosocial professionals1053 Volunteers28133 Chaplain635 Social worker743 Dietetitian540 Coordinator1146 Social therapist29 Bereavement counsellor014

13. DAY CENTRE

14. BEREAVEMENT SUPPORT GROUP

15. 2. Education programs on palliative care -Basic courses – 40 hours -Advanced courses for nurses– 40 hours -Courses for physicians -Courses for the members of interdisciplinary team ( psychologists, social workers, physiotherapists) BUT – lack of graduate and poor postgraduate education of physicians

16. 2. Education programs on palliative care Budapest Hospice House is an International Training and Resource Centre supported by OSI -International courses for EasternEuropean and FSU countries -40 hours training courses -Conferences and Seminars

19. 10th EAPC Conference, Budapest June 7 – 9, 2007

20. 10th EAPC Congress Budapest - 67 countries from all over the world - 2004 participants

21. 3. Publicity campaign on hospice Aims To promote the integration of hospice-palliative care into national health service To raise awareness of hospice- palliative care To draw the attention of policy makers on suffering, dying patients

22. Elements of the campaigne - 3 TV Spots were produced with famous artists -3 monthes were showen day by day 5 – 10 times in different TV channels -Air time was given free of charge

23. Testimony Kata Dobó Actress Movie Star Famous model

24. Testimony JUDIT HERNÁDI one of the most popular actress TV Star

25. Testimony IVÁN MARKÓ Ballet-dancer, choreographer famous world-wide Bejart Ballet

26. Publicity campaign Elements Adverts in printed and online media 100 billboards across Budapest Indoor adverts Press conference Interviews about our activities

27. BILLBOARD

28. INDOOR POSTERS

29. Publicity campaign Results (1)  Changes in awareness of lay people from 0% to 36 % of professionals growing demand for collaboration  More than 100 media publication in written and electronic media.  The campaign has drawn the attention on suffering people

30. Results May 2002 opening of the BUDAPEST HOSPICE HOUSE

31. Where is Hungary now? Increased number of PC services (2x since 2004) Legal development: 2004 - Minimum standards of palliative care - Ministry of Health decree on finance Finance: following the two year financial demonstration project for palliative care the health budget opened for new capacities in 2009 National development plan 2007-2013: integraton of Palliative Care into the National Health System Palliative care and psychosocial care became an integrated part of National Cancer Control Program in 2006

33. Thank you for the attention!