Death remains a taboo topic, causing many to die alone -- in hospitals or nursing homes. Since the late Sixties, the German hospice movement has been trying to change this, showing people that "dying is a part of life."
Only dying leaves are considered beautiful.
On the wall right next to the entrance of "Nepomuk House" hangs a tree cut out of paper. More than 150 leaves have been stapled to the trunk and its branches. Each of them contains a name and a date.
It's the date on which a person has died at this Cologne hospice. Doctors can't help those who come here, said Miriam Ahrens, who heads "Nepomuk House".
"But people don't necessarily come here to die," she said. "They come here if they're in pain. They want us to soothe the pain. They don't want to be alone when they die."
Helping people to deal with pain
Miriam Ahrens therefore considers it her job to enable her patients to lead a dignified life up to the end. As a result, a large part of hospice therapy focusses on pain relief: Those in pain can't enjoy life any longer, said Ahrens, who is fighting to keep joy in people's lives.
"Here, achievement has a completely different significance," she said. "For me, it's an achievement if someone can walk down the hallway without pain or says, 'For the first time in a long time, I slept well again last night' or 'I ate soup' of 'I watched TV.'"
Psychological problems are also something Ahrens helps to deal with. If unresolved conflicts prevent a patient from dying peacefully, she can try to come up with a solution.
But time is the most valuable thing the people at "Nepomuk House" can give: time to spend with the dying and their relatives. Those who deal with death, Ahrens has learned from experience, can let go and overcome their fear more easily.
Hospices still uncommon in Germany
Many elderly Germans still spend their last days in regular hospitals.
Few Germans experience the death of a loved one like this. That's why the global hospice movement is trying to encourage such a humane way of dealing with death.
In 1967, the first hospice for the dying was founded in the United Kingdom. There, as well as in the U.S., the hospice movement already has a much stronger base than in Germany, where 200 in-patient hospices exist so far. Volunteers in about 1,000 groups nationwide are also helping relatives of the terminally ill to care for their loved ones in an out-patient setting.
Looking after a dying person at home is a monumental task, said Patricia Bielstein, who has been working with the hospice movement for the past 15 years. Caretakers have to be on call 24 hours a day, hold back with their own needs and deal with the experience of death.
"Our goal is to prevent the dying from getting pushed off to a hospital," Bielstein said. "That's why we try to support relatives and enable them to take time off to go to the doctor or the hairdresser or just relax for a while."
Companions in death
Hannelore Zimmermann decided to become such a helper. A couple of years ago, the 68-year-old signed up with the hospice movement to get trained as a "companion in death." She didn't realize that her husband would be the first person to need her.
When Zimmermann's husband was diagnosed with cancer three years ago, she knew that she wanted to take care of him at home. In the beginning the couple hoped that he would recover, but at some point the doctor told them there was nothing else she could do.
Seeing little angels
"When the time came, he was still joking and said, 'I'm seeing little angels already,' because that's exactly what he felt," Zimmermann said. "Friday night –I was lying next to him – he said, 'We'll say good-bye now, I'll die tonight.' He didn't, but he fell into a coma and for me he was gone after that. His soul was gone, only his body was still here. And then he died on Monday."
Hospices help relatives to move on once their loved ones have died.
Facing death was painful and sad. But Hannelore Zimmermann didn't regret that she took care of her husband at home. On the contrary, she still lives on the experience.
"It's such a poignant event in your life and we consciously savored this dying and this illness," Zimmermann said. "We experienced it and suffered through it and that's why it's now a part of my life and has helped me to move on."