Transitions in End of Life Care: Hospice and Related Developments in Eastern Europe and Central Asia

By David Clark; Michael Wright et al. | Go to book overview

5
Conclusions and
recommendations

In this concluding chapter we set out first a summary of our analysis concerning all 28 countries included in this review, before making certain recommendations of our own about next steps.


Current levels of provision

In Figure 5.1 we present a timeline of hospice and palliative care developments for the whole region, beginning in 1976 and proceeding up to 2002. The events listed there summarize a remarkable history, which over a quarter century has led to a level of achievement difficult to imagine at the time of the first initiatives. In those years new approaches to the care of dying people were struggling to find expression within communist societies where health care systems gave little priority to individual needs and where basic physical care prevailed, rather than more dynamic models based on ‘holistic’ principles. Many of the achievements to be found in the timeline are products of years of hard work, lobbying and a determination to succeed, even in a hostile climate. They tell us something about the human spirit and also about the ability of first-generation pioneers to set up early service initiatives, usually in sub-optimal circumstances, but in the belief that to make a start is the most important factor. As the timeline develops, so we gain a sense of an international movement of like-minded individuals, drawn together to share experiences and to learn from one another. Gradually, the ideals and projects of individuals in specific locations begin to cohere into a wider sense of strategy and purpose. Indeed, despite the material poverty of so much palliative care in this region, its initiators have managed to maintain a high level of international contact and collaboration, which has proved a vital agent in stimulating growth in so many places.

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Transitions in End of Life Care: Hospice and Related Developments in Eastern Europe and Central Asia
Table of contents

Table of contents

  • Title Page iii
  • Contents v
  • Series Editor’s Preface vii
  • Foreword ix
  • Acknowledgements xi
  • 1 - Introduction- Background, Aims and Methods of the Review 1
  • 2 - Epidemiological and Policy Considerations 11
  • 3 - Palliative Care Developments across the Region 18
  • 4 - Palliative Care Beacons 176
  • 5 - Conclusions and Recommendations 269
  • Index 292
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