, Volume 15, Issue 6, pp 457-465
Date: 20 Apr 2007

Dying in Germany - consequences of societal changes for palliative care and the health care system

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The changes in the way people die and the new challenges in dealing with dying and death have not been realized to their full extent or discussed in respect to their implications and consequences for end-of-life care in Germany. The purpose of this problem analysis paper is to provide an overview of the most important societal changes and to address the consequences for end-of-life care in the German Health Care System from a public health nursing point of view. It will be demonstrated that an exclusive focus on fostering the development of palliative care as a form of specialized health care and thereby allowing only a few people access to qualified care at the end of life is not a sufficient approach. It will be rather necessary to make broad changes in all areas of health care in order to achieve a level of end-of-life care that is of high quality and appropriate to match people’s needs. The most important challenges to be managed in the German health care system will be presented and discussed.