Ulrike Grambow works in the inpatient hospice of the Christophorus Hospice Association Munich in an unusual double role: as a nurse and in housekeeping. Actually, the trained nurse and specialist for palliative care only wanted to help out temporarily in the kitchen, to bridge a bottleneck. But then she found that she is comfortable in both worlds- and both complement each other quite wonderfully. „My door is the food", says it today. Through this door it opens the senses and often reaches the soul of seriously ill people.
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„I want to die here, not eat.“
„Many come and say first: I want to die here, not eat", experiences Ulrike Grambow. And who wants to eat when he is tormented by drilling pain, constant nausea or shortness of breath?. In the hospice, with the means of palliative medicine and palliative care, these symptoms can often be significantly alleviated. If all attention is no longer focused on the pain, the vicious circle of shortness of breath and fear is broken, the appetite has a chance again. Ulrike Grambow might tempt you with a plate of soup or some ice cream. When the lightly glides through the throat, feels good and tastes fine, then the senses that are turned inward and are completely focused on defense open up again and ask for more. „When someone has a craving", says Ulrike Grambow "then we fulfill it as promptly as possible.“
Many of the people who spend their last days and weeks in the hospice today experienced the Second World War, the hunger of the post-war years, and the hunger of the war years. They tell Ulrike Grambow often from the time of the lack. Childhood with a growling stomach has left its mark on them in very different ways. One of them had to pick and eat so much sorrel that even today the thought of the wild herb gives her the creeps. The other loves barley grits to this day, more nutritious and sweeter though, simmered with milk, sugar and raisins.
What touches soul and senses
Part of caring for the dying is dealing with a person’s life story. Biography work is what professionals call it. How has a person lived, what was important to him, what burden he carries with him? Who plays a role in his life? What is he afraid of, what gives him pleasure, what does he like to see, hear, taste and smell?? Ulrike Grambow finds: Not only exploring what touches a person’s mind, heart and soul, but also involving their senses, that rounds out biography work and hospice care. A conversation about favorite foods can easily be an introduction to the deep issues of a lifetime. And also very practical aspects are important: Who can not swallow well, who loves spicy food? Ulrike Grambow carries such details from the resident’s bed directly into the kitchen and the appropriate dishes back again.
The fact that professionals in hospices and palliative care units work part-time is more the rule than the exception. Some employees have two mainstays, z. B. in the hospice and in educational work. In this way they find a balance to the fulfilling, but also stressful daily dealings with dying, death. Ulrike Grambow has an 80-percent position in an inpatient hospice. She works half in palliative care and half in housekeeping.
Oysters are not asked for
How much pure joy is exuded by an oven-warm yeast plait, the creamy potato soup, the crumbly-juicy crumble cake, a bunch of herbs whose greenness is diced. How much childhood comfort is in a spoonful of pudding, how much happiness in a bowl of chicken fricassee. „We tend not to be asked about oysters", says Ulrike Grambow dryly. It is usually the simple cuisine, the home cooking, the taste of childhood, that people long for at the end of their lives. The nut cake, the favorite vegetable. „A resident wished for rutabagas. It wasn’t easy to find them. And of course they didn’t taste the same as her mother’s. But she was happy and appreciated the effort.“
And one day: man stops eating
One day the time has come. The dying person no longer wants to eat. „Often they say: I must eat something. But they don’t have to anymore", says Grambow. „However, when someone stops eating and drinking, it is difficult for the relatives.“ To feed someone- After all, this is also an expression of the first, deepest care in a person’s life. Part of caring in the last days of life is accepting and enduring the fact that the loved one no longer eats. Well-intentioned, almost force-feeding does not stop dying; on the contrary, it only makes it more difficult. What often goes to the end: ice cream. „It cools nicely and slides well and is for most a fond childhood memory.“ And still later: ice cubes that moisten the mouth. „We freeze all kinds of things, juices, cola, prosecco.“
The world holds its breath
Eating and drinking keeps body and soul together. When a person no longer eats or drinks, death is usually only a few days away. The body loses its strength, the gaze turns more and more inward. The conscious moments become rarer. Ulrike Grambow calls it a gift when she is allowed to be present at the last breath of a person as the conclusion of a good terminal care. „When I was there for the first time, I compared the experience to the birth of my first son. The world held its breath for a moment. There one has already the feeling that between sky and earth some happens, of which we know nothing.“
„For me, it is a gift when I am allowed to be present at the last breath as a conclusion of a good accompaniment. When I was there for the first time, I compared the experience to the birth of my first son. The world held its breath for a moment. You get the feeling that there are things going on between heaven and earth that we don’t know about.“
And then? What to do then? When a person dies, Ulrike Grambow encourages the relatives to take their time: "It’s a unique moment when you don’t have to do anything at first.“ She encourages adults to bring children into the room as well. „Being left outside usually traumatizes children much more. To understand death, literally, that is an important moment.“ And, says Grambow: "Children have their own way of understanding death. „I once talked to a boy whose grandfather had just died. He said: "I don’t understand that the mummy is crying". Grandpa is going through the golden gate now and then he won’t have any more pain’.“
Sometimes Ulrike Grambow gives the children a stone for the "River of Memory". They are allowed to label and paint it and then place it with the others, which are lined up in the hospice garden like in a dry riverbed. While the adults are so terribly busy organizing the funeral and sorting out thousands of things, they then also have an important task. This is good for you.
Confirmation rally on the subject of dying
Ulrike Grambow’s work with children and young people often keeps her busy after hours. She volunteers for the project "Hospiz macht Schule" (Hospice makes school). About every six weeks, she organizes tours of the hospice for confirmation groups or visits school classes. She recently met confirmation candidates in their church. The young people started a rally on the subject of dying and death with a song by Die Toten Hosen. At several stations, they were able to find out about a wide variety of aspects. Ulrike Grambow always gets a few questions: About the age of the deceased, whether she also accompanies dying children, how stressful her work is for her. The young people have many questions; most of them only know about dying from hearsay. There is not much talk about it in the families. The "Hospice makes school" events ändern this often. The girls and boys take the subject home, into the world. A new generation is growing up, networked like never before: Perhaps in the future there will be more talk about dying.
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Gertrud B. (photo) has lung cancer and metastases on the spine. When she was transferred to the Christophorus Hospice in Munich, the doctors gave her eight days to live. When we visit them, it was a good three months ago.
„Putting the patients here and giving them a little morphine- that’s not all", says Dr. Marcus Schlemmer (photo), head physician of the palliative care unit at the Barmherzige Bruder Hospital in Munich. The people in his ward should be able to see, hear, feel, experience the world.
Where one lives, one could usually die well, too, finds Sepp Raischl, professional manager and deputy manager of the Christophorus Hospizverein Munchen e. V. "Surely an old person doesn’t need to be transferred from a nursing home to a hospice if he is not in pain …
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