Palliative Care Service

Larisa Anatolevna Shukshina,
Head of Departmentm Pediatrician 

Address: Ekaterinburg, 12 A, Agronomicheskaya St. 
Email: palliativekb@mail.ru  

There are 2 teams of health care providers, including: 
- a Pediatrician-Neurologist; 
- a Nurse; 
- a Medical massage therapist; 
- a Social worker; 
- a Psychologist. 

Palliative care for children involves all-inclusive and compassionate care aimed at preventing and relieving suffering for sick children or adolescents whose lifespan is limited due to a disease, which is not responsive to curative treatment. Pediatric palliative care is family-centered care, with the child and family enwrapped in the center of a circle of professionals addressing their spiritual, social, psychological, and physical needs.  

Palliative care is aimed at preserving and improving the quality of life of children with various incurable medical conditions of different nosological forms that limit or threaten the children’s lives from birth to 18 years of age. It also focuses on improving the quality of life of the child’s family members, providing an incurably sick child with the opportunity to be in a psychologically favorable family environment, creating conditions for social adaptation for raising of a disabled child with a serious illness. 

Palliative care for children is a separate sector in the health care and social systems. That is why it should not duplicate the already existing medical and social institutions (hospitals, clinics, intensive care units, oncohematological and rehabilitation centers, boarding schools, etc.). 

The main objectives of palliative care for children are the following: 

- To provide medical, psychological and social assistance to terminally ill children (with severe organic diseases of the central nervous system, mental disorders, genetic diseases, cancers and othernosological forms) and their family members; 
- To provide professional intensive health care at home; 
- To train family caregivers in skills usually provided by medical professionals in hospitals and nursing homes, to train in therapeutic massage techniques, elements of physical therapy aimed at improving the quality of life of a child with an incurable disease; 
- To comprehensively assess the children’s health status; to dynamically monitor the physical and mental development of terminally ill children; 
- To ensure compliance with the principles of palliative care, which should be humane, accessible, and free of charge; to make people understand the social significance and perception of death as a natural process of the life cycle. 

The palliative care for children in the Russian Federation started to develop after adoption of Federal Law # 323-FZ dated 21.11.2011 "On the basis of public health protection in the Russian Federation", where the term "palliative care" was defined for the first time. Article 36 determines this type of medical care as follows: “Palliative medical care is a complex of medical interventions aimed at relieving pain and alleviating other severe manifestations of the disease in order to improve the quality of life of the terminally ill citizens. Palliative care can be provided in outpatient and inpatient settings by medical personnel who have been trained to provide such assistance”.