in Cher, still without a specialized unit, the Bourges hospital hopes to open one this fall at the latest

The Minister of Health and Labor Catherine Vautrin must detail on Monday the government’s strategy for the next ten years in terms of palliative care. Twenty departments in the country do not have a palliative care unit.

Strengthening the provision of palliative care in France is considered by the government, as well as by caregivers, as an essential prerequisite for the introduction of assisted dying in France. For this, Emmanuel Macron has already promised that this strategy would include the creation of a palliative care unit in each of the 20 departments which still do not have one.

This is the case with Cher. At Bourges hospital, to compensate for this shortage, 18 beds dedicated to palliative care are distributed across several departments, explains Dr Anne-Claire Courau: “In the oncology department, three beds are dedicated to palliative care. There are others on the first floor, on the second floor at the other end of the hospital, and even in another branch of the hospital , on another site.”

Creating a palliative care unit would already make it possible to group some of these beds together. This would also make it possible to have more caregivers at the bedside of patients, who are sometimes at the end of their lives and require more listening and heavy care. Dr Courau recalls that “in a traditional acute medicine department, there is generally one nurse for 15 patients per day. In a palliative care unit, it is one nurse for six or seven patients per day, so almost double that in standard service.”

“Prevent pain from setting in”

Palliative care, care for pain, is essential, testifies Françoise, hospitalized for cancer which causes her enormous pain: “The nurses pull my ears a little, because I wait too long before saying that I’m in pain. In fact, here we teach you to say quickly that you’re in pain, to prevent the pain from setting in. “

In a palliative care unit, caregivers are authorized to dispense certain very strong pain medications more easily, explains Véronica Rigondet, also a doctor specializing in palliative care. “There are opioids, a bit like morphine but more powerful, which cannot be used in an ordinary hospital department and which are limited to palliative care units. A drug like ketamine can be introduced into this unit, then extended to the home or another department.”

The hospital management hopes to be able to open a palliative care unit in the fall at the latest, which could also accommodate so-called “complex” patients (suffering from Charcot’s disease for example) or requiring a tracheotomy. Today they are obliged to be taken care of in the surrounding departments. Several caregivers have already volunteered to work in the future palliative care unit.