In Nantes, the House of Nicodème comes to give depth to the last days

Here, a patient in a walker enjoys the green garden, where apples, pears, flowers and raspberries grow. In the living room on the ground floor, another settles down at the piano to play a few notes. On a table in the dining room, several generations of the same family are playing cards. Observing these scenes of ordinary life, one could almost forget that the patients received in the House of Nicodemus since last April no longer have any prospect of recovery (incurable cancers, organ failures, neurodegenerative diseases such as multiple sclerosis or Charcot’s disease).

Most will breathe their last within these walls, after a stay of a few days to a few months. “Sometimes a few hours, when families do not want this to happen at home”, slips Stéphanie Blino, manager of this establishment, who already manages a long waiting list. It happens that some patients only come here for a respite stay, or that their condition stabilizes and allows them to return home.

A place “capable of welcoming the fragility of life”, as its founders, a group of doctors, business leaders or association executives wanted from 2013. In this region that is under-endowed with palliative care, the regional health agency (ARS) then launched a call for innovative projects in 2016 and the founders joined forces with Saint-Thomas de Villeneuve Hospitality, which already managed medico-social establishments. Built thanks to mostly private donations, the Maison de Nicodème is supported by the Health Insurance for its operation.

Eliminate the medical aspect as much as possible

In this 18-bed unit, located on land in the diocese of Nantes and not backed by a hospital, the architecture of the premises and the furniture have been designed to eliminate the medical aspect as much as possible. In the rooms, offering a view of the outside, the sockets and pipes necessary for treatment are hidden behind a sliding plate, covered with a poster. Relatives can sleep on site, and everyone has access to comfortable lounges, a bright dining room and a terrace with colorful chairs.

The medical team works hand in hand with about twenty trained volunteers, who go to the bedside of the sick every day, after medical authorization. “Sometimes we offer silent listening by going to the rhythm of the patient’s breathing, explains Edith de Rotalier, volunteer at the Maison de Nicodème association. We can also discuss, accompany them in the garden or in town, if it is feasible. We seek to ensure that everything that happens here is as intense as possible. »

Focus on patient needs

So that each minute spent at Nicodème takes on depth, the caregivers model their organization on the needs of the patients. “There is no question of waking them up at 6 a.m. to take their blood pressure, describes Doctor Michèle Drieux, who shares her time with a palliative care unit in the north of the department. We don’t take families out during treatment, unless they want to, and we are as discreet as possible when they are there. »

At the moment, the house welcomes patients aged 40 to 96 and as many different wishes: to taste mussels and fries despite an inability to eat pieces (the cooks know how to adapt the textures…), to go for a day by the sea , shopping in town, celebrating a wedding anniversary planned before the aggravation of the disease… Sometimes, the heaviness of care complicates certain requests, which are always discussed in a multidisciplinary team (with psychologists, physiotherapists, occupational therapists…). “We don’t say no, even if it would be simpler, says Michèle Drieux. But we answer that we will do everything to get there. »

In a society that willingly keeps death at a distance, Nicodemus’ team hopes to spread a culture of palliative care. “Faced with the cult of performance where you have to have a young and healthy body, fragility is scary, continues the doctor. Some patients feel guilty for imposing their presence on their family and even caregivers. We must fight this feeling of uselessness. »


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