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See what "Palliative care" is in other dictionaries. Social organization of palliative care.

First, let's understand the terminology, because many people confuse concepts. "Palliative medicine", "palliative care", "hospice care", "Supportive therapy" or "Supportive care".

Palliative care

It is an approach that aims to improve the quality of life of patients and their families facing a life-threatening illness. Rendering palliative care means the prevention and relief of suffering through the early detection, careful assessment and management of pain and other painful physical symptoms as well as through psychosocial and spiritual support.

In other words, palliative care is care aimed at providing the highest possible comfort and social support for an oncological patient, it does not set itself the goal of curing the patient, but is aimed at improving the quality and maximizing the life of an oncological patient. Palliative care turns out to be both at the patient's home and in inpatient medical institutions.



Palliative medicine

Palliative medicine refers to palliative care- palliative chemotherapy, palliative surgery, or palliative radiation therapy. They are prescribed to cancer patients by the attending oncologist in the case when radical treatment is impossible. Palliative medicine aims to curb the progression of the disease (that is, to stop tumor growth) and prolong the patient's quality of life.

Example palliative surgery- This is a tracheostomy (when the tumor covers the larynx), gastrostomy (to artificially feed a patient with esophageal cancer), colostomy (with intestinal obstruction caused by tumor obstruction).

It is necessary to understand that neither palliative chemotherapy, nor palliative radiation therapy, nor palliative surgery will cure radically, they will lead to a decrease in intoxication, a decrease in pain syndrome and improving (as far as possible) the condition of the cancer patient due to tumor control.

Supportive help

This is the prevention and elimination of the negative impact on the body of a malignant oncological disease and anticancer treatment. That is, it is detoxification, antiemetic, symptomatic pharmacotherapy, as well as psychological support. This applies to physical symptoms and psychosocial problems, as well as side effects cancer treatment throughout the entire period of the disease, including rehabilitation and support for people who survived with a cancer diagnosis.

The difference between palliative and supportive care is that supportive care is always part of the main treatment (eg chemotherapy), while palliative care for cancer patients has an independent scope.

Hospice care

The underlying philosophy and definitions of palliative and hospice care have a lot in common.

The purpose hospice care is caring for the patient as a whole person, helping in solving all his problems - related to the physical, emotional, social and spiritual spheres of life. In hospice care is provided to the patient who is approaching the end of his life and to those who love him.





Staff and volunteers work as part of an interdisciplinary team to provide assistance whose primary goal is to relieve pain, dignity and care for the patient.

The main thing fundamental difference hospice from palliative care means that hospice care means that the main anticancer treatment is stopped because it is either ineffective or impractical.

While palliative care and special anticancer treatment do not exclude, but complement each other, thereby increasing the effectiveness of therapy.

Elements of palliative care should be carried out from the very first days of treatment of an oncological patient. This will improve the quality of his life at all stages and provide the attending physician with more opportunities for anticancer therapy. It's just that in the early stages of the disease, palliative is an adjunct to the main anticancer treatment, and as the disease progresses, when anticancer treatment has already been completed (canceled or ineffective), palliative care becomes the only method of therapy.

Objectives of palliative care

  1. Selectionpain reliever and supportive care for relief of symptoms, as well as treatment of complications that appear in last months life.
  2. Psychological and emotional support of a cancer patient and his relatives. This is due to the fact that when feelings arise, caused by thoughts of imminent and inevitable death, the support of specialists is very important.
  3. Religious or spiritual support so that the patient has the opportunity to ask questions about his life, its meaning and death.

Thus, the tasks of palliative care for cancer patients are the relief of pain and other symptoms, as well as the solution of social, psychological and spiritual problems. It is designed to ensure, as far as possible, best quality the patient's life until the very end. These tasks show the need for joint work of various specialists - doctors, psychologists, social workers, priests.


Where is palliative care provided?

  • In a specialized hospital

If the cancer center has a palliative care unit, then the incurable patient is provided with assistance to relieve symptoms and improve the quality of life. For example, this is the treatment of complications such as intestinal obstruction, ascites, dyspepsia, peritonitis, and intoxication.

  • In day care departments

Day hospitals are organized to provide palliative care to lonely patients with limited mobility. In a day hospital setting, patients can receive not only the necessary medical advice, but also important psychological support. Thus, by visiting the day hospital 2-3 times a week, the patient gets the opportunity to get away from home loneliness, which also has a beneficial effect on the quality of life.

  • At home

Often palliative care turns out to be at home, in the home and in the most comfortable conditions for the patient, surrounded by loved ones.

Here, a specialist, namely a palliative care doctor, explains in detail to family members how to care for a cancer patient, prescribes an adequate regimen for taking pain medications, talks about eating and cooking habits, and is in touch in order to adjust therapy in time or just give the necessary advice on time. ...

The hospice is a public institution intended for incurable cancer patients to provide symptomatic treatment, the selection of the necessary analgesic therapy, the provision of medical and social assistance, care, psychosocial rehabilitation, as well as psychological support for relatives during the period of illness and loss of a loved one.

Medical assistance, qualified care for an incurable patient in a hospice is provided free of charge. Hospice care provides wide circle tasks, including medical, social, psychological and spiritual. This is an active relief of symptoms and their stressful effect on the patient and his relatives. Hospices are staffed by doctors, nurses, social workers, clergymen and volunteers. In general, teamwork, as we have already said, is considered the basis of palliative care.

The hospice has an onsite palliative and home care service. "Hospice at home" provides intensive, inpatient-like medical and patient care at home. In some European countries in France or Finland, for example, hospice at home offers intensive medical care and a service that allows patients who need hospitalization to stay at home. It is a type of treatment that is much more like inpatient treatment in a hospital than conventional home care.

pallium- blanket, cloak) is an approach that improves the quality of life of patients and their families facing the problems of a life-threatening disease by preventing and alleviating suffering through early detection, careful assessment and treatment of pain and other physical symptoms, as well as providing psychosocial and spiritual support to the patient and his loved ones.

The term "palliative" comes from the Latin "pallium" which means "mask" or "cloak". This determines the content and philosophy of palliative care: smoothing - mitigating the manifestations of an incurable disease and / or covering with a raincoat - creating a cover to protect those who were left "in the cold and without protection."

Goals and objectives of palliative care

Palliative care:

Goals and objectives of palliative care:

Palliative medicine

Palliative medicine- a branch of medicine whose tasks are to use the methods and achievements of modern medical science for treatment procedures and manipulations designed to alleviate the patient's condition, when the possibilities of radical treatment have already been exhausted (palliative operations for inoperable cancer, pain relief, relief of painful symptoms).

Palliative care is different from palliative medicine and includes the latter. Russian Association of Palliative Medicine http://www.palliamed.ru/

Hospice care

Hospice care is one of the options for palliative care, it is a comprehensive care for a patient at the end of life (most often in the last 6 months) and a dying person.

see also

Russian Association of Palliative Medicine http://www.palliamed.ru/

Notes (edit)

Links

  • First information / resource site for palliative / hospice care (2006)
  • Council of Europe Recommendations Rec (2003) 24 to member states on the organization of palliative care
  • Methodical recommendations for the organization of palliative care approved by Ministry of Health and Social Development of the Russian Federation 09/22/2008 n 7180-rx)
  • A Brief Clinical Guide to Palliative Care for HIV / AIDS. Edited by Doctor of Medical Sciences, Professor G. A. Novikov. Moscow, 2006.

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See what "Palliative care" is in other dictionaries:

    Palliative care- 3.4 Palliative care: A direction that aims to improve the quality of life of patients and their families facing an incurable (life-threatening) disease, which is achieved by alleviating suffering through early ... ... Dictionary-reference book of terms of normative and technical documentation

    Palliative medicine- - the field of health care, designed to improve the quality of life of patients with various nosological forms of chronic diseases, mainly in the terminal stage of development in a situation where the possibilities of specialized treatment ... ... Encyclopedia of Newsmakers

    Palliative care- 1. Palliative care is a complex medical interventions aimed at getting rid of pain and alleviating other severe manifestations of the disease, in order to improve the quality of life of terminally ill citizens ... ... ... Official terminology

    Children's hospices in Russia and the world- Hospice is the basic structure of palliative medicine for helping seriously ill people in terminal condition (when organ damage is irreversible), who have more days and months to live than years. Palliative ... ... Encyclopedia of Newsmakers

    World Day of Hospice and Palliative Care- is held on the second Saturday in October. In 2013, this day falls on October 12. The organizer is The Worldwide Palliative Care Alliance (WPCA). The Alliance includes national and regional ... ... Encyclopedia of Newsmakers

Palliative medicine Is an approach to improve the quality of life of patients and their families facing life-threatening illness by preventing and alleviating suffering through the early detection, accurate assessment and treatment of pain and other physical, mental, psychosocial and spiritual problems. Palliative care is an integrative area for effective work which requires a network of doctors, nurses, home help workers, social workers, spiritual mentors, program managers, child care workers, volunteers, psychologists, pharmacists, staff rehabilitation centers, staff providing support to family members of the patient.

A holistic approach involves focusing on four groups of issues:

  • Physical - Symptoms (complaints of discomfort), for example: pain, cough, fatigue, fever;
  • Psychological - anxiety, fears, sadness, anger;
  • Social - family needs, problems related to food, work, housing and relationships;
  • Spiritual - questions about the meaning of life and death, the need for peace (harmony and harmony).

Many people think that palliative medicine is about helping patients in the last few days of their lives, but in fact it is about alleviating suffering and improving the quality of life since the discovery of an incurable disease. The goal of palliative medicine is not to lengthen or shorten life, but to improve the quality of life so that the remaining time - be it days, months or years - is as calm and fruitful as possible.

Palliative medicine can help with:

  • HIV infection;
  • Cancer;
  • Severe renal or heart failure;
  • Terminal stage pulmonary diseases;
  • Progressive neurological diseases;
  • Other life-threatening diseases.

Hospice (from English hospice) - medical institution in which patients with a predictable adverse outcome of the disease receive decent care and services. Hospice patients are surrounded by the usual “household” things, and relatives and friends are free to access them. The medical staff provides palliative care: patients can receive oxygen, pain relievers, tube feeding, etc. Minimum doctors and maximum middle and junior medical staff... The main purpose of staying in a hospice is to brighten up the last days life, ease suffering.

The staff of the Palliative Care Center are certified specialists in anesthesiology and oncology with special training in palliative care in oncology. They consult cancer patients at all stages of the disease, including late and advanced cases, give recommendations on complex palliative treatment, which is aimed at improving the quality of life of patients.

Palliative care should be provided to patients with cancer when the first pathological symptoms, and not only with the decompensation of the functions of organs and systems. Palliative care is not an alternative to radical treatment for operable forms of malignant neoplasm, being an adjunct to the main treatment, however, it becomes leading as the disease progresses.

The main goal of palliative care is to improve the quality of life of patients, and not to prolong it by any means.

The consultation includes:

I. Pain therapy:

  1. assessment of the severity and type of chronic pain syndrome,
  2. selection of pain medications
  3. prescriptions for analgesics and
  4. discharge detailed diagram their drug intake by the hour,
  5. therapy for specific neuropathic pain;
  6. therapy of psychogenic components of pain syndrome in oncology
  7. breakthrough pain treatment.

II. Symptomatic pharmacotherapy therapy:

  1. correction of hematological disorders,
  2. therapy gastrointestinal disorders(nausea, vomiting, diarrhea, constipation);
  3. correction of respiratory disorders pharmacological agents,
  4. treatment of specific skin disorders (itching of the skin, pruritus);
  1. nutritional support, advice on appropriate nutrition, correction of gastrointestinal disorders (nausea, vomiting, diarrhea, constipation);
  2. providing advice on the conservative treatment of polyserositis (ascites, accumulation of fluid in the pleural cavities);

III. Nutritional support

  1. selection rational regime nutrition and appointment health food,
  2. correction of gastrointestinal disorders;
  3. assessment of the patient's nutritional status;

IV. Ethical and legal aspects palliative care in oncology, connection with hospices.

Conversation with patients and relatives about the methods and possibilities of palliative care, where, by whom, how, when it is at the patient's place of residence, about the process of prescribing potent and narcotic drugs, the rights and obligations of patients in the field of opioid analgesics.

V. Xenon therapy

This method is based on inhalation of therapeutic doses of medical xenon. Xenon (Xe) is an inert gas contained in the air in microconcentrations, absolutely harmless to humans, non-toxic, does not cause allergic reactions... Xe has a wide range of therapeutic effects (analgesic, neuroprotective, cardioprotective, antispasmodic, anti-stress, antidepressant, immunostimulating, anti-inflammatory) that can be used with therapeutic purpose in various fields of practical medicine:

  • Xenon therapy is effectively used in the treatment of acute and chronic stress disorders, to relieve psycho-emotional stress, anxiety, depressive conditions and insomnia;
  • It is possible to use xenon during and after treatment of the underlying disease, to relieve the stress associated with treatment and improve the quality of life;
  • Received nice results in the treatment of pain (postoperative, vertebro- and discogenic nature, neuralgia, tension headaches, migraines);
  • Xenon therapy is used in cardiology to stabilize hemodynamics and improve functional state myocada, which is especially important for the prevention and treatment of heart attack and angina pectoris;

After the procedure, the patient experiences pleasant sensations, the mood improves.

Consultation:

Dr. med. Abuzarova Guzel Rafailovna
head of the palliative care center for cancer patients

M.Sc. Lapina Svetlana Evgenievna

M.Sc. Stanislav Kuznetsov

Neurologist at the Center for Palliative Care for Cancer Patients

What is palliative care.
The term "palliative" comes from the Latin "pallium" which means "mask" or "cloak". This defines what palliative care essentially is: smoothing - hiding the manifestations of an incurable disease and / or providing a cloak to protect those left "in the cold and unprotected."
While palliative care was previously considered symptomatic treatment of patients with malignant neoplasms, now this concept extends to patients with any incurable chronic diseases in the terminal stage of development, among which, of course, the bulk are cancer patients.
Currently, palliative care is a direction of medical and social activity, the purpose of which is to improve the quality of life of incurable patients and their families by preventing and alleviating their suffering, through early detection, careful assessment and relief of pain and other symptoms - physical, psychological and spiritual.
According to the definition, palliative care:

  • affirms life and considers death as a normal natural process;
  • has no intention of extending or shortening the life span;
  • tries to provide the patient as long as possible active image life;
  • offers help to the patient's family during his serious illness and psychological support during the period of bereavement;
  • uses an interprofessional approach in order to meet all the needs of the patient and his family, including the organization of funeral services, if required;
  • improves the patient's quality of life and can also positively influence the course of the disease;
  • with a sufficiently timely implementation of measures in conjunction with other methods of treatment, it can extend the life of the patient.

    • Goals and objectives of palliative care:
    1. Adequate pain relief and relief of other physical symptoms.
    2. Psychological support sick and caring relatives.
    3. Developing an attitude towards death as a normal stage in a person's path.
    4. Satisfaction of the spiritual needs of the patient and those close to him.
    5. Solution of social and legal issues.
    6. Solution of issues of medical bioethics.

    Can be distinguished three main groups of patients requiring specialized palliative care at the end of life:
    • patients with stage 4 malignant neoplasms;
    • patients with AIDS in the terminal stage;
    • patients with non-oncological chronic progressive diseases in the terminal stage of development (stage of decompensation of cardiac, pulmonary, hepatic and renal failure, multiple sclerosis, severe consequences violations cerebral circulation and etc.).
    According to palliative care specialists, the selection criteria are:
    • life expectancy no more than 3-6 months;
    • evidence of the fact that subsequent attempts at treatment are inappropriate (including the firm belief of specialists in the correctness of the diagnosis);
    • the presence of complaints and symptoms (discomfort) in the patient, which require special knowledge and skills to carry out symptomatic therapy and care.

    Inpatient palliative care institutions are hospices, palliative care departments (wards) located on the basis of general hospitals, oncological dispensaries, as well as inpatient institutions. social protection... Home help is carried out by specialists from the field service, organized as an independent structure or being a structural subdivision of an inpatient institution.
    The organization of palliative care can vary. Given the fact that most patients would like to spend the rest of their lives and die at home, home care would be most appropriate.
    To meet the patient's needs in comprehensive care and different types assistance requires the involvement of various specialists, both medical and non-medical specialties. Therefore, the hospice team or staff usually consists of doctors, nurses with appropriate training, a psychologist, social worker and a priest. Other professionals are called in to provide assistance as needed. The help of relatives and volunteers is also used.