(Rivista Internazionale - December 1995: The Order’s hospitals and structures for the elderly in Germany - 2/5)

The centrality of the patient and the participation and motivation of staff are decisive factors in the changes now occurring in health policy in Germany. The recent health service reform law has laid greater emphasis on the cost-benefit ratio in hospitals and this year it also applies to elderly people's welfare organisations, thanks to the introduction of compulsory insurance on welfare. The tendency is to limit time, spent in the «medical centre» model, with services before and after hospitalisation, out-patients' surgery and a differentiated tariff system. In this situation the Malteser structures in Germany intend to make their services especially accessible to those people who, in the new payment system, will have particular need of their help.

Julich. «Malteser Krankenhaus St. Elisabeth», with departments of internal medicine, surgery, gynaecology and obstetrics, ear, nose and throat and ophthalmology, is situated in the Nordhein-Westfalia Region, Aachen.

In many cases these are elderly and sick people requiring long convalescent periods, signifying special medical treatment and nursing, social and spiritual assistance. Therapy for continuous pain, palliative medicine departments for the terminally ill and geriatric rehabilitation are only some of the central concepts in looking after and accepting the sick in their God-given individuality and their own personal dignity. But the German Maltesers also feel it is necessary to highlight their charitable vocation in the more advanced sectors of medical science, to be able to exercise their influence in the ethical issues on the borderlines of medicine. These include questions of prenatal diagnosis and its repercussions on obstetrics, human genetics and organ transplants.
The processes under way in the hospital world also mean shorter stays in hospital wards, leading not only to empty beds but also to deficiencies in post-operative assistance.
To compensate for this, hospital and welfare structures for elderly people are also developing their own projects. One of their advantages is that they are co-ordinated with the numerous services and programmes of the entire Malteser organisation. This interrelation among the different services is already being successfully exploited; greater integration accompanied by greater enhancement are the big opportunities for the future.
There have rarely been such favourable conditions for co-ordinating hospital care with home assistance and other welfare forms, uniting them under the same roof of the Maltesers' organisation. Already today efficient schemes of interaction are being offered in the care of elderly people. The Maltesers will have increasing chances to establish nursing homes for the aged and for those needing intensive care nation-wide. And with their mobile services they will be able to ensure extensive autonomy to the fitter elderly people in their own flats, offering social services such as meals-on-wheels and life-line. Finally members, volunteers and doctors of the «Hospice» movement ensure support and comfort for dying or acutely afflicted patients.

Karl-Ferdinand von Thurn und Taxis

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