Perspectief 2020-48

2020-48 Assistance provision to relatives of an incurable patient 49 professionals, volunteers, or paid carers 40 . It should be noted here that the major part of the palliative care costs in the Netherlands is covered by basic medical insurance 41 . That is why the care of the incurable patient usually does not cause financial problems to the relatives 42 . However, supporting care of family caregivers is not included in the basic medical insurance package. To ensure better or additional support to relatives, one should have supplementary insurance. Moreover, no private insurance company in the Netherlands shall cover the costs of supporting relatives in the period of grief 43 . 4 Development and establishment of palliative care in Ukraine Ukraine belongs to the countries where palliative care is only under development. There exist only some centers of palliative care provision 44 , despite the fact that Ukrainian culture has a long tradition of caring for the dying people. In particular, with the proliferation of Christianity, in the territory of modern Ukraine there appeared the first monasteries where, the same as in other European states, shelters for sick people were founded. During XVI- XVIII century A.D., such shelters were run by almost every monastery, which at the time cared mainly for the dying Cossacks 45 . First modern hospices were founded only in 1996 in Lviv, Ivano-Frankivsk, Kharkiv, and Korosten (Zhytomyr region) 46 . Today there are 66 different services providing palliative care in Ukraine. Like in the Netherlands, the care of incurable patients is provided mostly in a hospital context. In particular, there function 50 inpatient palliative care departments in hospitals. In addition, there are 7 inpatient hos- pices, and 9 teams provide palliative care at home 47 . There are also 3 inpatient hospices for children, 6 home and 3 hospital programs for looking after incurable kids. In the whole of Ukraine, only about 1.5 thousand terminally ill patients can receive qualified palliative care in an inpatient facility 48 . According to the estimations based on the WHO standards, Ukraine needs around 4 000 hospice beds in inpatient institutions and over 85 000 more of terminally ill people require palliative care at home on a daily basis 49 . Based on the data collected by Ukrainian experts, 500 000 people with incurable diseases require this type of care, as well as 1.5 – 2 million of their relatives and close people 50 . Thus, less than 10% of patients at the terminal stage of illness get palliative care in health care institutions and at home 51 . It should be indicated that the equipment and resources of functioning hospices