Lisbeth Malene Nielsen, a clinical nurse specialist with 28 years of experience, discusses the importance of open communication about death and the holistic approach to palliative care at Sankt Lukas Hospice in Hellerup, Denmark. The hospice, which provides care for patients with life-threatening illnesses, focuses on relieving suffering and improving quality of life in the final stages of life.

The Sankt Lukas adult hospice in Hellerup provides a tranquil environment for 24 patients with life-threatening illnesses. The staff at the hospice work with palliative care, focusing on relief and quality of life for patients whose curative treatment has stopped. Approximately 20% of patients are discharged to receive palliative care at home.

Nielsen emphasizes the concept of “total pain,” which addresses the physical, psychological, social, and spiritual needs of patients. She facilitates “professional reflection” sessions for the hospice’s 42 nurses to discuss ethical dilemmas and process the emotional demands of their work. These sessions use conversation prompts to encourage reflection on their interactions with patients.

Nielsen notes that the majority of patients at Sankt Lukas are cancer patients, but the hospice also serves those with COPD, heart failure, ALS, and kidney or lung diseases. The hospice’s outreach team provides palliative care in patients’ homes, collaborating with home care services. Nielsen’s role includes supporting the nurses and addressing their concerns, acknowledging the intense emotional challenges they face.

The increase of patients admitted to Sankt Lukas Hospice shows the growing need for end-of-life care. Admissions rose from 308 patients in 2014 (with 70 discharges) to 397 in 2024 (with 95 discharges). In the first quarter of 2025, 261 people were referred, with 105 admitted to the hospice and 53 joining the outreach team.

Nielsen also touches on the role of faith and spirituality in coping with death, highlighting that spirituality extends beyond religion to encompass music, nature, and personal beliefs. She acknowledges the difficulty some patients have in discussing death, often due to a “shield of love” protecting their families from the painful reality. The hospice staff assists patients in expressing their feelings about death if they wish to do so, while respecting those who prefer to focus on life.