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Antea Worldwide Palliative Care Conference

Rome, 12-14 November 2008


Presenting author Palliative care for HIV people in Milan: three years of experience in Hospice
Agostino Zambelli
Author: Agostino Zambelli
Email: Luigi Sacco Hospital has always been involved in caring AIDS last phases of life.
Our hospital has 90 beds for infectious disease patients, and supported a strong burden during all
Phone the HIV epidemic, in spite of the global number of HIV positive people followed in Milan (about
10% of the whole Italian cases).
The deaths of HIV people till 1995, year of introduction of HAART, were daily and personnel
Mobile phone was not prepared to face this problem.
We started with experimental home care in 1992 and, finally we arrived to open the Hospice in
april 2005. This was an important event because, before the opening, all patients died in the
hospital or had to be sent in the only Hospice which accepted HIV positive people, far from
Please underline the most Milan.
appropriate category for your Our Hospice was born for HIV positive patients, but from the first moment it was open to all
abstract terminal patients, trying to avoid the stigma that burden HIV people.
Our Hospice is a part of the network for AIDS patients, comprehending Shelters, Home Care,
• Pain and other symptoms
Outpatients and Day hospital.
• Palliative care for cancer patients From the opening we followed in the Hospice 335 pts, mean age 66y, 212 males and 123
• Palliative care for non cancer Females. 123 HIV pos, 56 Infectious non HIV (hepatitis B, C, Creutzfeldt Jakob disease), and
patients 156 not infectious (neoplasm, cardiac failure, cerebral failure, etc).
• Paediatric palliative care
The most important differences we evidenced between HIV positive and the other terminal
patients in our Hospice could be resumed in four groups: prognosis (difficult to establish and
• Palliative care for the elderly
define in HIV people), fever and other symptoms due to infections (opportunistic or not), privacy
• The actors of palliative care
(a big problem in HIV patients), social burden (familial problems, strangers, transsexuals, etc)
• Latest on drugs Need of pain therapy is lower in HIV patients than in cancer patients, while the use of sedative
• Pain drugs is usually higher.
A special training has been established for nurses, doctors, psychologists, volunteers working in
• Illness and suffering through the Hospice, both initial and permanent.
• Marginalisation and social stigma
at the end of life
• Palliative care advocacy projects

• Prognosis and diagnosis
communication in
different cultures
• Communication between doctor-
patient and patient-
• Religions and cultures versus
suffering, death and Session: Non cancer palliative care
Chair: Dott. M. Fantoni
• Public institution in the world:
palliative care policies
and law
• Palliative care: from villages to
• Space, light and gardens for the
terminally ill patient
• End-of-life ethics
• Complementary therapies
• Education, training and research
• Fund-raising and no-profit
• Bereavement support
• Volunteering in palliative care
• Rehabilitation in palliative care
• Palliative care quality indicators
• Neurology in palliative care