Walking on cobblestones in the old historic town of Prague is a question of mindfulness  and balance.  I practice my mindful walking meditation as I take each step, hoping that my well heeled boots do not get caught up in the gaps between these ancient stones.  I know there is a metaphor for life hidden somewhere in these stones. Tram #15 will take me on the journey to the suburbs where Cesta domu’s offices reside.

Cesta domu is the Czech term for ‘ Coming Home’.  Veronika Drnkova, Psychologist and Grief Counselor, meets me in the courtyard of an old stone building.  We enter to large open spaces where I see nurses, counselors and outreach staff at work for their community, caring for the seriously ill in Prague. Plants and several bikes decorate the entrance along with an extensive display of books and brochures that offer visitors information and materials on Palliative Care and Cesta domu.  Veronika is coordinating the evening service for the yearly memorial gathering, flowers, food and book venders, while still graciously introducing me to various staff members. I am reminded of my mindfulness practice earlier while walking on cobblestones.  Palliative care practitioners, wherever they are, must be masterful at keeping the balance of the multiple tasks involved in the delivery of palliative care in the home and community.

Currently, Cesta domu cares for about 300 patients yearly in their homes. Families contribute to this service from their own funds. Neither government insurance nor private insurance pays for hospice service so it remains necessary to raise funds from various sources. Cesta domu promotes their service with multiple hospital providers.  The physician or hospital staff offers patients and families information about Cesta domu upon discharge from the hospital.  The family then must make the initial call to the hospice and request the care. The outreach into the community is significant thanks to the work of Lenka Vanova  and Linda Tichotova Frycova.

Do they really use bikes to visit patients? Katerina Tichotova, RN, shared that the bikes are there for the nurses to make home visits in the local neighborhoods. One of Katerina’s patients died in the night and she had been out very late, nonetheless she arrived early in the morning to speak with me.

Katerina had been an ER nurse where the focus of patient care is to ‘ stabilize and send.’ She lived close to the Cesta domu and often saw nurses coming and going on their bikes.   After talking to some nurses from the hospice, she became intrigued and soon decided to begin her professional path into the hospice world. Katerina found the role of ‘being with’ her patients and their families challenging, yet very rewarding. Relationships with patients/families took on new meaning as she accompanied them on this end-of-life journey. Katerina shared that she had received very little education on Palliative Nursing prior to her coming to Cesta domu and appreciated the wisdom of her peers and ELNEC training.  I shared our Coursera Palliative Care Courses and she was genuinely enthusiastic.

Soon our time together came to an end and I left Cesta domu feeling energized and renewed as if I too had come home to a group of like-minded souls who shared a commitment and passion for palliative care.

For more information on Cesta domu  https://www.cestadomu.cz/en