The procedure for providing palliative care to adults and children

What does palliative care mean?

These are medical measures aimed at alleviating the condition of patients with incurable diseases accompanied by severe pain. The approach allows to improve the quality of life of patients.

Palliative care is indispensable for both people with mental and ailments regarding organs and systems.

This approach has several features:

  • Treats death as a normal process, but creates the conditions for a struggle for life.
  • Not intended to prolong or shorten the life of the body.
  • Focuses on pain relief and the ability to lead an active lifestyle.
  • Is to support the patient's family.

Aims and objectives of

One of the main goals is to help seriously ill people at home and maintain a desire for life.


  1. Anesthesia and relief of pain.
  2. Psychological support of the sick and loved ones.
  3. Developing a healthy attitude towards death.
  4. Satisfying spiritual needs.
  5. Solution of the problems of medical bioethics.

History of development in Russia

The very word "palliative" is derived from the Latin "pallium".In translation means a veil, a raincoat.

In a broad sense, it is characterized by protection from adverse effects and providing comfort. In a narrow sense, it is aimed at creating appropriate conditions for people who, according to medical forecasts, have not long to live.

The origins of palliative care go to nursing homes, hospices, almshouses, shelter homes. They arose even in the Middle Ages with churches and monasteries. On the shoulders of special people went care for incurable patients. Only in 1843 was the separation of these institutions, depending on the purpose.

In Russia, the first mention dates back to 1682.Then the Tsar Fyodor Alekseevich ordered the creation of a guardian, special houses-hospitals for the poor and heavy sick.

Modern palliative medical evolved during the second half of the 20th century. First they talked about her only in relation to cancer patients.

In 1987, based on the MNIOR them. PA Herzen created one of the first cabinets to help patients with severe pain. In 1994, the Moscow City Hospital No. 11 opened a palliative care unit. Today there are 130 structural subdivisions in various regions. Another 58 are in the formation stage.

Concepts and principles of palliative care for the adult population and children

Palliative care is provided on an outpatient basis, in a 24-hour or day-time hospital.

Responsibility for its timely provision is on the state, public health authorities, public institutions.

The cabinets aimed at helping patients with incurable diagnoses are created with many hospices and hospitals.

In them:

  • supervise the patient's general health,
  • prescribes medicines,
  • issues referrals to inpatient medical facilities,
  • sends patients for consultation to doctors,
  • advises,
  • carries out measures aimed at improving the patient's emotional state.

When working with children, the condition of parents is taken into account. The main task is to provide opportunities for full communication, providing the baby with a good mood.

Since children feel pain several times more sharply than adults, the main principle is the use of any legal methods aimed at alleviating the general condition of the patient.

Palliative for adults and children is based on the principles of observance of moral and ethical standards, respectful and humane treatment of the patient and his relatives.


Such services represent state, municipal and private health systems. Information to the patient is communicated by the treating physicians and using any other sources.

Interaction of the palliative care offices occurs with various charitable, voluntary and religious organizations.

In this office there is a doctor who has passed special refresher courses, a nurse. Under the new rules, the day hospital does not provide for the provision of a palliative. Most patients receive it at home or in the walls of hospitals.


Three groups of patients are identified, to whom palliative care is provided in full. Patients:

  • with oncology of the 4th stage,
  • AIDS in the terminal stage,
  • with progressive diseases in the terminal stage of development.

Patients with diseases in the stage of decompensation and with the inability to achieve remission, patients with consequences of cerebral circulation, with irreversible trauma, degenerative diseases of the nervous system become clients.

Palliative care for oncological patients

Maintaining an acceptable level of quality of life is an important task in oncology. Adequate conditions of existence are created.

In an inpatient setting, patients who can not be completely cured of an ailment undergo manipulations designed to alleviate severe symptoms.

For example, if radiotherapy relieves severe pain, then palliative chemotherapy is aimed at reducing tumor tissue. It allows to reduce intoxication by products of tumor metabolism.

The main principles of working with cancer patients are:

  • psychological support,
  • rational nutrition,
  • correction of disorders by the digestive system,
  • pain control.

Palliative at home

When treatment is passed, but the disease progresses, the best solution is getting help at home. Specialists from the service come on schedule or on call of relatives, the patient himself.

If necessary, strong analgesics can be used in the process.

A health nurse may visit the child on their own or do this with a doctor. At work, the patient's mental and physical condition is taken into account. Active therapeutic measures are carried out only if the patient chooses.


In the conditions of the hospice, palliative work is carried out not only by medical personnel, but also by volunteers. The patient is sent to the institution for activities aimed at stopping pain and reducing shortness of breath.

The main indications for receiving care are:

  1. The need to find methods and conduct adequate treatment.
  2. Carrying out actions that can not be carried out at home.
  3. Lack of relatives who could help at home.

Center in Moscow

The center is organized on the basis of the Moscow DZM Order No. 106 in 2015.The task is to provide palliative care to patients at home, in the hospital. The implementation of modern methods to improve the quality of life of patients is being implemented.

The center consists of a hospital designed for 200 people, a branch of the visiting visiting service. The main focus of the work is to help incurable patients with progressive diseases and ensure continuity in the work of institutions that provide such assistance.

Video about the types of palliative care for incurable patients:

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