Question 1. My father is 78 years old. In the final stage of lung cancer. He received chemotherapy and radiation therapy for a long time. Doctors said that no oncological treatment can be done anymore, only supportive treatment should be given. We cannot take care of it at home. He had to be under the supervision of health personnel. He is affiliated with the social security institution. No hospital accepts our patient, including the hospital where he received his treatment. He says he has nothing to do. Is that possible? Where should we apply with our patient?
Answer 1. The condition of patients like your father is called the “terminal period” in medical language. It means a patient who has reached his last period. Unfortunately, the condition of these patients has always been a problem in today’s Turkey, and it still is. In developed countries, there are terminal patient care centers called “hospices” for such people. Here, under the supervision of nurses and even doctors, it is aimed that patients spend their last period comfortably and painlessly. Physical and psychological support is provided. In this way, the burden of the relatives of the patients who are already under great stress is also relieved.
So much so that this service can be provided at the patient’s home, and is continued under the supervision of the health personnel until the patient’s life ends. Institutionalized systems for terminal patients in our country are very inadequate. There are groups of home care service universe for this. However, their number is insufficient and the costs are too high for most families to bear. The Social Security Institution also does not cover these costs. In fact, most of the private insurances do not cover these patients. Most hospitals also do not accept such patients.
Under all these circumstances, the luckiest ones are unfortunately the few people who are in good economic condition and who were able to have their patients comprehensively insured on time. Patients in this situation can somehow stay in hospitals or receive home care services. However, the number of these people is negligible. This is really a big problem for Turkey. Living knows this. Patients, families and specialists experience these pains very closely. But the subject is foreign to most people in the pursuit of life. However, it should be cultivated in the consciousness that not only life but also death is a reality and that it should be lived painlessly and in a way that befits human dignity.
It is the most correct way to bring the issue to the agenda of the government as soon as possible and to include hospital or home care services within the scope of social security for recent patients.
Prof. Dr. Coşkun Tecimer
