It is Christmas time, a time to share moments with family and friends, even if they are virtual, but many cannot fully enjoy it. The Psychology Degree of the Villanueva University has launched an initiative in which several students and their teacher visit terminally ill patients.
The project is integrated into the Service Learning Program (ApS), which combines academic learning and community service processes in a single project. In this program, 42 students are trained to work on real needs of the environment with the aim of improving it and acquire competencies, skills and ethical values, strengthening their civic-social commitment.
"The academic environment is often devoid of the real thing, in books everything works, but sitting in front of a patient is a different event, a unique experience," explains the head of this project, Alonso García de la Puente, who is a professor at the Universidad Villanueva and director of the psychosocial team of the Laguna Care HospitalThe students attend the center. "It's an impressive experience," says Rocío Cárdenas, a fourth-year psychology student at the university.
Alonso García de la Puente (Mérida, 1984), has a degree in psychology, studied at the Pontifical University of Salamanca, was in the business world for a while, but eventually completed a master's degree in psycho-oncology and palliative care at the Complutense University. Professor De la Puente has been working for eight years at the Hospital de Cuidados Laguna, which specializes in caring for the elderly and treats and cares for patients with advanced diseases. He has been at Villanueva University for three years. This is how he explained the initiative to Omnes, which includes some comments from Rocío Cárdenas.
- How did you come up with the idea of combining your teaching at Villanueva with the direction of the psychosocial team in Laguna?
The subject of Villanueva came up in a talk I gave to a group of young Catholics. One girl was impressed and told her mother, dean of the Faculty of Psychology, about it. I was invited to give a talk on palliative care at the University. The dean and even the Rector were there, and then they asked me if I would like to collaborate with them as a professor. That was the beginning of my journey as a professor at Villanueva, in 2019.
- Tough pandemic times. How would you sum up your years at Laguna? How many people have you cared for in that care hospital?
It is the most life-changing thing in my life history. In my team, we see about 600 people a year, plus their families, which is twice as many. For each person, we see an average of two family members.
We all remember that when we left the university, the feeling was: I don't know anything. A lot of knowledge, but not knowing how to put it into practice or apply it. The University has a very nice program, Learning and Service (ApS), for volunteering, linked to the subjects. It consists of putting into practice what you are learning, that is, learning in practice by giving a service to society.
In this case, we are thinking of making an agreement between Laguna and the university, so that students can come. My subject is Health Psychology. We selected a patient, who has knowledge of his illness, who is able to speak, and the students began to come. Some came in person, and the rest connected online. It was a real laboratory for practicing the subject.
- Tell us a little about the students' experience in the project.
It is a unique experience for them, to be able to face a patient, and especially this type of patient in an end-of-life situation; it transforms them professionally and personally on most occasions. They learn from experience, they integrate from reality. For the hospital, it means being able to share our culture of care. Expanding a compassionate outlook, a discipline to continue to look at the challenges of a chronified society with a long life expectancy. For the students it is very enriching.
Gradually, students move from thinking about themselves, what am I going to say to the patient, etc., to thinking about the patient and being patient-centered, through dignity therapy.
Rocío CárdenasThe patient was the first one the whole class saw, the first contact. It was very shocking, not only from a psychological point of view, but especially from a human point of view. Knowing his condition, we saw the need to be much closer and more caring with him. The project allows young people like us to connect with the experience of death. We have seen a person in his early 50s whose life is ending because of an illness. [Rocío Cárdenas also adds: "A personal experience of mine has been to consider that the work to which God can call me has been that love. That is, to bring heaven forward to those people who are dying"].
- We continue our conversation with Professor García de la Puente: What does dignity therapy basically consist of?
It is a therapy that has a series of structured questions, like a guide, but that allows us to inquire into the patient's life, making a vital review, so that we can connect their self. When people reach the end of their life, or are very ill, they may think that they are no longer who they were. With dignity therapy, the person is able to see that there is a continuum in their life, that they are still the same person, and it connects them to their self. It is also a way to connect with others, with their family, with society, and to realize that this has existed throughout life, how they have been able to help, how they have contributed...And it also connects you with the transcendental: who I am, and what I leave behind me. The legacy that is left, that story is transcribed just as the patient has told it, it is given to him, it is edited, and he distributes it to whomever he wishes, or says to whom he wishes it to be given, thus leaving a sense of legacy, of connection with the transcendental.
For the students, apart from psychology and learning, it is a task that we try to carry out from Laguna. This center not only wants to take care of people, but to take care of a culture, which we are losing, and that we live in a society that is sick, that is having a bad time. The pandemic has pushed it to the limit, and we have realized what was happening, although we were not doing anything to fix it. It's this phenomenon of independence, of people not needing anybody. This is also something that the students learn. We realize that we are not independent, but co-dependent, that we live in a society in which we have to trust, that we have to take care, that suffering exists. And that we should not despair.
- Are you referring to the euthanasia law?
I am referring to that law. In the end, these things tell us about the kind of society we are, Facing the end of life puts you far in front of the truth. Because at the end of life, everything accessory disappears. Your car, who you are, your last name, the neighborhood you come from, your job, even your physique has changed. Nothing you had belongs to you anymore. Through this, people also realize that it is worth caring, that it is worth continuing to learn, to continue studying, to try to alleviate the suffering of these people, not to cut it off, to kill it, but that one can truly train in compassion, in humanism, and accompany the person in suffering, and make that suffering tolerable, because we cannot eradicate it, but we can learn to make suffering tolerable.
- What is your opinion on the lack of specific training in palliative care in Spain? You state that 45 percent of patients in Spain die without receiving palliative care. How do you assess this figure?
Spain does not yet have a specialty in palliative care. This is a huge problem, because when there is no specialty, there is no formal training in palliative care, and there is no recognition, neither socially nor administratively. This figure of 45 percent means that almost half of the population dies in poor conditions.
Many people die suffering, and without receiving the necessary care to work through their suffering at the physical, emotional, social and spiritual levels. Palliative care brings a new look at the patient's vision, moving from a biomedical model to a biopsychosocial and holistic model, treating and looking at the patient from all parts, integrating and attending to them. There are many countries where there is a palliative care law. Chile, for example, has just passed a comprehensive palliative care law. We are a support team, and this means that we come in at the last moment, when little can be done for the patient. Palliative care should come in much earlier, even at the time of diagnosis of the disease.
Professor Alonso García de la Puente and his wife have a baby girl who is only a few months old, it is 8:30 in the morning, and we do not keep him more than a quarter of an hour. But we would have chatted for a good while longer.
