A Table for Our Own is just one of the campaigns implemented by Hospiss LV. The main goal of the organisation is big and important for the whole society - to revitalise hospice care in Latvia, to get the legislation in order so that the service can be received as soon as it is needed and that the service is at least partly financed by the state. Ilse's conviction is that the passing of a person should be treated with the same care as birth, giving the person who is leading the last days of life all the support and security needed to make this time truly peaceful.
Volunteering
The idea of hospice care came about when I realised that I wanted to do something worthwhile and useful for society on a voluntary basis. Ilze says: "It was three years ago - supporting seriously ill people seemed like the right topic for me. At that time, there were volunteer courses available and my partner Ilze Zosuli and I completed the course. Alongside the training, we started to learn about hospice work in Europe and Russia. When we visited a hospice in Moscow, we saw that palliative patients were treated to meals specially prepared for them. There it was called teleжкa радости - the trolley of joy. In 2019, we started to implement this idea in Latvia - we called it the Festive Table, we approached different restaurants, we came with a new spirit and a feeling that palliative care and the end of life can be perceived in a less dramatic way. We wanted to change attitudes because while a person is alive, they have wishes and interests and it is important to understand how to enhance that spark of life once survival has become predictable." Ilze and her like-minded friends visited the 1st Riga Hospital and the palliative ward of RAKUS Biķernieku Hospital with the food trolley. "When we entered the wards and also studied the system, we realised that there is a great lack of hospice in Latvia - a special place where everything these people need is taken care of. Patients can stay in hospital palliative care wards for a while and then have to go home. No thought is given to what happens if relatives are not ready to provide proper care, if the person has nowhere to go," says Ilze.
Own organisation - Hospiss LV
Hospices have existed around the world for at least 40 years. After learning about the experience of hospices in Europe and Russia, Ilze and her colleagues decided to fight for the Latvian state to introduce this service. "The only way we could fight was to set up a non-governmental organisation. The first and main goal of our statutes is to promote the concept of hospice in Latvia. We asked linguists for the Latvian version of the word, but we stuck with the name that is known and understood all over the world." The pandemic made some adjustments to the organisation's plans, but this is exactly why the idea of the Table for Saviours campaign was born. "We hope that everyone who donated to this medical support campaign asked themselves what the word hospice in our organisation's name means."
A table for your own - from the heart
Ilze recalls: 'With the restrictions on kovids, we could no longer go to hospitals with food trolleys. But people wanted to help, and we had already arranged for supporters, cooks. So we started another campaign - A Table for Our Own. We took as many as 1000 portions a day to the medics. This campaign has been running for more than a year now. We see it not as a catering campaign, but as a solidarity and support campaign. And this is not a story about a medic not being able to take lunch from home. It's about someone else! We started because we felt at that moment that we could not do otherwise. April and March last year was a confusing time - we didn't know what to expect, how the medics would fare. This campaign was about changing public attitudes, about solidarity with the medical profession. Aunties brought tangerines, children made little savings baskets to donate - it was everything! We are grateful to the donors. Of course, as time goes by, everything changes and changes are reflected in such a sensitive area as charity." Last summer, Hospiss LV discontinued the Table for Saviours campaign. When the emergency ended, it seemed that Latvia had coped well with the epidemic, but then came autumn. "I didn't have the courage, but our donors from DEPO called and urged me to resume the campaign. It's true that there were already different reactions from the medical community, and it was difficult to understand who needed it and who didn't," says Ilze.
Giving medics a break
But the organisation continues to care for medics by giving them a break from their hard work in hospitals. "We think that the 'Rest for our own' campaign is really useful - it is an opportunity for medics to go away for three days and relax in one of Latvia's rural guesthouses. We don't discriminate about who gets a break. The management of each hospital passes on the message to those who need it. This opportunity has already been taken up by the doctors of the Stradiņš Hospital's metal department, and is currently being offered to the doctors of the Infectiology Centre." Ilze reveals that the initiator of the campaign is someone who has been burnt several times in his life. He is also the first donor. Many guesthouses give the opportunity to doctors to rest for free. The campaign will continue throughout the summer.
For a peaceful end of life
Ilse's big pain is still the lack of hospices in Latvia: "Hospice is different from palliative care. A palliative or terminally ill patient can be there for ten years, for example. Hospice, on the other hand, means that life expectancy is predicted and it is the last six months of life. Why should a person miss out on appropriate care at the end of life? Why does the state not take care of this? At the moment, the care of the sick person is left to the relatives, and they have to be emotionally and physically prepared for it." Latvia's hospitals have nine palliative care units where a patient can stay for seven to ten days. After that, you have to pay for it, which is not a small sum and not everyone can afford it. "We have spoken to patients - hospitals are not the kind of place where you want to stay for a long time. Patients would like to go to a hospice - a home for dying people, where they would be cared for according to their needs, washed, cuddled, fed, taken outside. The family could return to active life with peace of mind about their loved one." Ilze is convinced that the state should take over the hospice and she and her like-minded colleagues are fighting to make the state hear: "We have written many letters to the Ministry of Health and the Ministry of Welfare, but to no avail. We had a dream - we would do a pilot project, for example, providing hospice care for ten people. We show how the service should work (we have carers, a chaplain, a doctor, a nurse, a physiotherapist, a psychologist, volunteers), ministry officials assess the costs and decide how much of the costs can be covered by the state budget. But we have not made any progress on this issue. We have received praise from the Riga City Council that we are doing well and that the Riga City Council wants to introduce a new service, but so far we have no support. We have similar communication with the ministries." However, Hospiss LV is not folding its arms. "Everything is happening - we are taking huge steps and we have done a fantastic amount. We are currently organising free care for six clients with the donations we collect, and we are cooperating with the Latvian Samaritans' Association. It will take at least two months to set up a social home care service. This was arranged for two patients: one managed to receive the service for two weeks, the other for only three days. This means that in a bureaucratic circle, people have no chance of getting a service when they really need it."
Hospiss LV house on top!
Hospice is an indicator of social well-being, says Ilze. "People have lived, worked and paid taxes in this country. Why should he feel marginalised and unnecessary at the end of his life? When we talked about this in the Ministry of Health, they hit us on the shoulder - good for them! But when we asked for one hospice doctor and one nurse to work with our carers, we got nothing." There will be a hospice house after all. A suitable location is being found, work is underway and Ilze hopes that by July it will be able to accommodate the clients who are currently being cared for in their own homes. "Yes, we are only in Riga for now. When the first hospice house becomes operational, all the questions will be answered and the holes in the legislation that need to be sorted out will be clearly visible. If in a few months we move into our little hospice with five beds, that will be fantastic! Someone will be able to plant flowers, someone will be able to bring their dog, someone will be able to get out after being trapped in their flat and not being able to see the sun." To ensure that the work is done properly and that the service is of high quality, the organisation has provided training for 70 volunteers through a licensed programme.
Hope to be heard
Ilze repeatedly emphasises that hospice does not cure the client, it only alleviates the symptoms. "In a hospice, the priority is the individual needs of each client - for one, it is important to have an oxygen concentrator bottle available at all times, for another - to have their cat with them or, for example, to always have someone nearby who holds a phone to their ear three times a day when they call their daughter." Negotiations with ministries have so far failed to yield results, but Ilze hopes that the situation will change: "We are waiting for the state to amend the legislation to reduce the bureaucracy in receiving the service. If a GP says, for example, that John needs hospice care, he gets it the next day, and he can choose whether he will be cared for at home or in a hospice house. Properly organised hospice care focuses on the moral support of the family - they are there, they can talk through what is important and they know that their loved one is not suffering. At the end of life, it is important that the person can strengthen their spirituality and enter the finishing line with peace of mind, with their loved ones by their side."
Make a wish come true!
Last year, Hospiss LV launched the campaign "Fulfilled with wishes". However, the campaign was put on hold by the Kovids, but one day it will again fulfil the wishes of dying people. "The stories are so emotional! For example, there was a young man, Alexander, with rapidly progressing pancreatic cancer and he had a wish to catch catfish in the Daugava River. Everything had already been arranged, but he refused to go - he was afraid that if he died in the boat, he would cause problems for his doctors. The conversation about catching catfish revealed that Alexander's relationship with his son had broken down and they had not seen each other for several years. I found the guy on the internet and showed Alexander pictures of his son. Alexander asked to print them. A few hours after the doctor brought him the pictures, the man died. After his death, he was cremated and his ashes were scattered in the River Daugava, with the doctors and nurses present. Yes, it is probably unprofessional to say goodbye to a patient like that, but it was the most beautiful funeral I have ever attended. Everything that is thought of, built around the departure, heals those left behind." Nothing ends with death - that is Ilse's conviction: "It is a sacred process, and neglecting it destroys the peace and sanctity of the moment. If it is possible to lessen the pain of leaving for someone, it is worth it. The experience, emotions and satisfaction I have gained over these two years are incomparable. I want the State to fulfil its functions. Then let us all plant hospice gardens together and make Latvia the best place in the world for the last stage of life."
Source: Aptiekāra Žurnāls JUNIJS 2021 Magazine publisher - AS RPH Marketing Latvia.
Thanks to Zanda Jankevica for the interview!
