Clarification letter from ActiVite about night care
26-10-2023 -
Recently, ActiVite, through the palliative care nurses, sent a letter to the general practitioners about night care. The appeal of the letter is mainly intended as: do not promise too much to the patient and leave the assessment to the palliative nurse/district nurse (a similar appeal is often made by district nursing to doctors in the hospitals with regard to the expected home care.
Here is some clarification:
- At the start of ReBOZ (cooperating home care organizations in the night with regard to acute district nursing), a vision on night care was developed by the home care organizations concerned. This roughly comes down to: at night you sleep and there are no planned care moments. This vision was the starting point for what the ReBOZ was and was not for. And led, for example, to different planning of care moments and more solutions with regard to aids.
- The letter that was recently sent is NOT about the use of the ReBOZ: this remains unchanged (and will soon even be expanded to include the care pathways that we agree on under the flag of care coordination).
- The letter that was recently sent DOES concern terminal night care, or ‘waking care’ (in the letter PTZ: palliative terminal care). PTZ is someone who is present with a patient for an entire night. The reason why this is requested can be very diverse and is not always about real ‘care’. As with all district nursing, an indication from the district nurse is required (and the district nurse must adhere to the frameworks of the ZVW). There is little room for such long-term care. The letter from Activité indicates that the necessity and possible alternatives will be looked at even more critically (e.g. also a number of nights by family or other informal caregivers or medical students or volunteers). We are also looking at the possibility of temporarily deploying a care provider until an alternative has been realised. This had already been used by ActiVite and is now being further tightened to a policy of ‘No, unless’. This is in line with the national movement that, where possible, more tasks are shifted from formal to informal care (‘appropriate care’).