MIL OSI Translation. Region: Russian Federation –
In the former building of the city clinical hospital No. 68 named after V.P. Demikhov will open a nursing home “Lyublino”, designed for 86 beds. It is planned that he will receive the first patients in December.
On the eve of World Hospice and Palliative Care Day Sergei Sobyanin visited the branch of the Moscow Multidisciplinary Center for Palliative Care, which is undergoing major repairs. In a few months, the Lyublino nursing home will be opened here.
“We continue to develop the palliative care program in Moscow. We have organized home visiting assistance, which today simultaneously serves about 17 thousand people. The hospital bed fund has been expanded – about a thousand beds are currently working under the palliative care program. And there is a large program for the creation of new nursing buildings – there are about 500 more beds. That is, in fact, inpatient palliative care in Moscow will increase by 1.5 times, ”Sergei Sobyanin said.
According to him, the city plans to develop outpatient palliative care, since most of these seriously ill people are at home under the supervision of relatives. “This is, in principle, correct, but for this it is necessary, of course, to provide them with medical assistance, to give timely painkillers and so on,” the Moscow Mayor said.
He stressed that palliative care is a difficult, difficult, but very necessary direction. “I am grateful to everyone who devoted their lives to this profession, to this direction. I hope that through the efforts of the city, in cooperation with public organizations, charitable foundations, this situation will significantly improve, ”added Sergei Sobyanin.
Nursing home “Lyublino” will be opened in the former building of the city clinical hospital No. 68 named after V.P. Demikhova. The building, built in 1958, is located at the address: Shkuleva street, house 4, building 2.
The overhaul began in June 2020. At the moment, the final finishing has been completed. Specialists install engineering and medical systems, as well as improve the surrounding area. The facility is 95 percent complete.
“This is the first of five buildings to be put into operation. Absolutely all typical design solutions are made according to the standard. And Muscovites will no longer need to think about where is better, where is worse, where a close relative will be more comfortable. It will be equally good everywhere, ”said Anna Federmesser, head of the Moscow Multidisciplinary Center for Palliative Care.
She noted that the institution will meet European standards with a high level of comfort. Highly qualified personnel work here, there are all painkillers. “We have a happy city in this sense, no matter how sad this topic is,” said Anna Federmesser.
To equip the nursing home, more than five thousand units of modern medical equipment and other products will be purchased in the amount of 174.2 million rubles. It will install modern ultrasound and ECG machines and a mobile X-ray machine. This will allow the necessary diagnostics to be carried out in the department or right at the patient’s bed.
The patients of the new medical facility will be people who need constant nursing care, including patients with moderate to severe cognitive impairment, such as senile dementia or Alzheimer’s disease.
The capacity of the institution will be 86 beds. The nursing home will employ 210 people – nine doctors, 151 nurses and nurses, and 50 other staff.
Comfortable rooms are designed for one to three people. They are equipped with a private bathroom, TV, refrigerator and necessary furniture, including an individual serving table and a locker for personal belongings. Patients will be accommodated in modern beds with anti-decubitus mattresses and an electric drive, which allows changing the position of the bed in the vertical and horizontal planes.
For people with limited mobility, sanitary facilities are equipped with ladders, special toilet chairs, a personnel call system, handrails and other devices. Each room will be equipped with lifts and ceiling systems for movement.
With the help of special screens, it will be possible to isolate the patient’s bed for communication with relatives and performing intimate procedures. In addition, patients will have at their disposal separate rooms for communication with relatives, as well as a prayer hall. Outgoing patients will be able to spend the last hours of their lives in separate wards.
Our own laboratory will provide express diagnostics of the main indicators of blood and urine, which is necessary for dynamic monitoring of the condition of patients. The hospital pharmacy will provide all the conditions for storing an adequate supply of potent pain relievers.
It is expected that the first patients will receive nursing home “Lyublino” in December. Also in 2021-2022, the Moscow Government plans to complete the overhaul of three more buildings of the Palliative Care Center to accommodate nursing care units at the following addresses: Akademika Millionshchikova Street, Building 1, Building 2 (113 beds) and 1st Shchipkovsky Lane, Building 19, Buildings 1 and 2 (84 beds).
In addition, it is planned to complete a major overhaul of the building with 101 beds in November this year. It is located next to the main building of the Palliative Care Center at 6 Dvintsev Street, Building 1.
Thus, in 2022–2023, about 300 nursing beds for elderly patients will be organized in Moscow.
Palliative care center
The Moscow multidisciplinary palliative care center was established in 2015 on the site of the former city clinical hospital No. 11, which specialized in providing medical care to incurable patients. The building is located at 6 Dvintsev Street.
In 2017, the first Moscow hospice named after V.V. Millionschikova. It included eight branches in different districts of the capital:
– in the Central Administrative District (Khamovniki district, Dovator street, house 10);
– in the Northern Administrative District (Zapadnoe Degunino district, Taldomskaya street, building 2a);
– in the South-West Administrative District (Severnoe Butovo District, Polyany Street, 4);
– in the North-Eastern Administrative District (Rostokino district, 1st Leonova street, building 1).
– in the Southern Administrative District (Biryulevo Vostochnoye district, 3rd Radialnaya street, building 2a);
– in Zelenograd Administrative District (Kryukovo district, Zelenograd city, building 1701);
– in the North-West Administrative District (Kurkino district, Kurkinskoe highway, building 33);
– in the SEAD (Nekrasovka district, 2nd Volskaya street, building 21).
The total number of beds for adult patients in the Palliative Care Center is 440.
In 2019, the ninth branch was opened – the First Moscow Children’s Hospice, designed for 30 beds. It is located at: Chertanovskaya Street, 56a (Chertanovo Yuzhnoye District).
The branches of the Palliative Care Center employ 1,521 people – 233 doctors, 520 nurses and 768 nurses and other staff.
Specialists offer patients symptomatic treatment (relief of severe manifestations of the disease), teach relatives to take care of the patient on their own, provide psychological and psychotherapeutic support, and advise on social issues.
Patients receive the necessary assistance both in inpatient conditions and at home.
Development of palliative care in Moscow
More than 80 thousand people, including about three thousand children, need palliative care in the capital every year. Inpatient care is provided at the Palliative Care Center and its eight branches, as well as at 13 hospitals and one non-state clinic. The institutions have deployed about a thousand palliative beds. And children receive help in four hospitals (101 beds).
To provide palliative care at home, 19 outreach services have been organized: for adults – 18, for children – one. Their functions include:
– provision of medical care to terminally ill patients with difficult to control severe manifestations of the disease;
– writing prescriptions at the patient’s bedside;
– pain relief with potent drugs at home, including narcotic and psychotropic;
– provision of medical devices for home use;
– performing complex dressings of pressure ulcers and tumor decays at home;
– organization of individual fasting at home (heavy death of a non-transportable patient, especially difficult social situation).
Since 2018, narcotic and psychotropic drugs, as well as prescriptions for such drugs, have been included in the arrangement of doctors for the provision of palliative care at home. This allows you to quickly stop severe symptoms at home without hospitalizing the patient. One team for pain relief works in Moscow around the clock.
For six months of 2021, field service staff visited about 80 thousand patients at home. In addition, the House with a Mayak children’s hospice makes a huge contribution to the provision of palliative care to children on an outpatient basis. It is a private medical charity.
A palliative care coordination center operates around the clock, which helps to resolve emerging organizational issues such as registration, transportation, referral of medical personnel for home care and hospitalization, including transportation. Thanks to his work, since 2018, the transportation of over 19 thousand patients in need of palliative care has been organized. Center phone: +7 499 940-19-48.
There are 79 pharmacy organizations in Moscow that dispense narcotic drugs and psychotropic substances by prescription. Of these, 26 have the right to manufacture them. Attached to these pharmacies are the Moscow Multidisciplinary Center for Palliative Care, its branches (hospices), as well as the House with a Mayak charity foundation.
In 2021, 9.4 thousand patients were provided with narcotic and psychotropic drugs. All of them receive medical care on an outpatient basis.
The Palliative Care Center provides patients who are monitored at home with medical rehabilitation equipment and consumables. For example, since the beginning of this year, 754 adult patients have been provided with the necessary equipment (809 units). These are 139 ventilators, 581 oxygen concentrators, 89 coughs. During the same period, 162 children were provided with respiratory support equipment.
In addition, a memo for doctors and patients has been published, which contains all the information about pain relief therapy. Employees of medical organizations regularly conduct trainings, seminars, speak at medical and nursing conferences and medical forums. There they talk about the provision of palliative care, the treatment of chronic pain syndrome.
For relatives of terminally ill patients, the hot line of the Vera Charitable Foundation operates around the clock: +7 800 700-84-36.
Palliative care during the COVID-19 pandemic
Initially, during the pandemic, two hospices were redesigned to provide palliative care to patients with coronavirus infection – the branches of the Butovo and Nekrasovka Palliative Care Center. The buildings were redeveloped and sanitary checkpoints were organized.
The Nekrasovka hospice received patients with coronavirus from May 28, 2020 to April 27, 2021. The Butovo hospice has been operating since the beginning of the pandemic to the present day. Also, from October 2, 2020 to February 15, 2021, palliative care for patients with coronavirus was provided at the Degunino hospice.
During this time, 965 patients with COVID-19 received palliative care.
Plans for the development of palliative care in Moscow
They plan to develop palliative care in Moscow further. Thus, they want to increase the number of field services and visits to patients who are at home, to expand the provision of medical products, medicines, and specialized health food products. There are plans to increase the number of palliative beds and the provision of nursing beds in their composition for patients who do not need round-the-clock medical assistance, but who need qualified nursing care.
The system of professional training of medical personnel will also be developed, and those medical organizations that provide palliative care will be more staffed. In addition, the development of interdepartmental interaction between medical, social organizations and socially oriented non-profit organizations is expected. This will help to find a multidisciplinary approach to providing patients and their families with comprehensive palliative care. It includes medical and psychosocial support.
In addition, the city plans to develop perinatal palliative care.
EDITOR’S NOTE: This article is a translation. Apologies should the grammar and or sentence structure not be perfect.