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- Between exhalation and inhalation: how seriously ill patients are cared for in Russia
Between exhalation and inhalation: how seriously ill patients are cared for in Russia
Helping to care for seriously ill, palliative, or even injured patients is an inconspicuous and quiet matter, but extremely important for loved ones who are unable to take care of themselves. Especially considering that this process involves many nuances and requires special training. Who and how takes care of those who can no longer do without help is described in the Izvestia article.
From hygiene care to laundry
In Russia, families caring for the seriously ill can count on government support, including assistance with movement, personal hygiene and laundry. Single people without relatives receive home care, psychological support and leisure activities through social workers and specialized institutions.
In the Republic of Buryatia, for example, the long-term care system is actively developing and implemented through interdepartmental interaction between social and medical institutions.
— It is a comprehensive support program for elderly and disabled citizens who have partially or completely lost the ability to self-serve. The goal is to provide an opportunity to live in familiar conditions and support families providing care," the expert noted.
The Aelita Social Support Center also functions in this way. A team of 128 social workers, nurses and lawyers provides food and medicine delivery services, as well as household tasks such as cleaning and laundry throughout the republic, including remote areas.
At the same time, the head of the non-profit organization Aelita, Aryuna Mylzenova, in a conversation with Izvestia, noted that the availability of assistance is higher in large cities. This is largely due to the opportunities for special training in the field of seriously ill care — the main medical and educational institutions are concentrated in megacities.
— In small towns and rural areas, there is a shortage of qualified specialists and limited access to training. To close this gap, it is necessary to develop distance education programs, create mobile field services and encourage the involvement of specialists in remote regions through various forms of support and motivation," said Mylzenova.
Where there is help, there is hope.
St. Alexy's Hospital is a multidisciplinary medical institution of the Russian Orthodox Church with 302 beds, providing medical care to people of all faiths. Branches in the Ivanovo, Moscow and Yaroslavl regions are engaged in palliative care. Since April 2022, the hospital's training center has trained 1,537 nursing volunteers who help in hospitals in Moscow and the Moscow Region, as well as in Donbas.
Natalia Anikina, a teacher at the St. Alexy's Hospital Training center for the care of the wounded and a volunteer, said that the nurse's care training includes not only professional skills, but also the ability to treat the wounded with respect, compassion and support.
— The courses at the St. Alexy's Hospital Training center teach the basic principles of caring for the wounded and the rules of safe movement: how to take care of a patient, how to turn or move him so that he does not harm either the patient, himself or his back; the rules of infection safety in order to protect himself and patients, techniques and methods of care, the expert shared.
Hygiene, changing clothes, washing, haircuts, shaving, and feeding help the wounded person to feel that they are being taken care of, and to know that they are not alone, forgotten, or abandoned.
— When we come to the hospital, we try to do it in the most comfortable and appropriate way. For example, depending on whether a fighter is able to move or sit, we choose different washing methods. If a person is in serious condition, the nurses wash him right in bed. It is important not just to perform the procedure, but not to hurt the patient's sense of dignity. If a person is immobilized, unconscious, or severely injured, he remains a person who deserves respect," Anikina said.
After being injured and after everything they have experienced, people are in a psychologically difficult state. The caregiver's task is to understand how best to fully support a person.
— Just imagine: a healthy man was living an active life, and suddenly, for example, he doesn't have a hand, but he needs to call, get dressed, wash dishes, which previously seemed elementary. When you need time to adapt, to train your body to perform these functions in the absence of a hand, people get lost, angry, powerless or depressed," Natalia Anikina emphasized.
The expert stressed that it is important not to strive to do everything for a person. For example, if a patient has an amputated arm and does not yet have a prosthesis, you need to teach him how to walk with one hand or use special devices. The main thing is to support his desire to be independent. A well-thought-out action plan can greatly help here: if a person sets small but achievable goals for himself, this increases his self-confidence.
— It happens that loved ones tell such people that they fully understand, but if you have two legs, then you are unlikely to fully understand a person who has lost both legs. It is important to treat with patience and empathy, to search and find a solution together. It is important that he understands that this is not the end of life, that life goes on, although there is a lot to learn anew. The support of family and loved ones is of great importance here," Anikina said.
Do not harm a loved one and do not lose yourself
One in three Russians faces the need to take care of a loved one who is seriously ill, said Anastasia Goltsman, chief physician of Medscan|Golden Care. At the same time, caring for a loved one who is seriously ill is not an easy task that requires constant involvement. One in four of those involved in caring does not always manage to find time for themselves and replenish their own resources. You often have to give up your job, hobbies, and interests.
— Despair, guilt, anger, aggression, increased anxiety, and constant fatigue are among the most common feelings experienced by loved ones. In palliative care, caring relatives are called "secondary patients": because of the burden of care that has fallen on them, they risk their own health," Goltsman shared.
She noted that the key to preserving one's own strength is delegating worries. In particular, you can at least partially relieve yourself by contacting other relatives, friends, social services, and charitable foundations with a request to help organize care. It is important to recognize in time that it will not be possible to stay in the ranks for a long time without delegation and distraction.
— Do not forget about the routine of the person involved in the care: brushing teeth, combing hair, taking a shower, regular nutrition, well—adjusted sleep give a feeling of support and help to stay in shape, - the expert emphasized.
At the same time, excessive care can interfere with both the patient and the carer — it will drain the resource without giving anything in return. This happens when caring relatives consider it their mission to cure their loved one or achieve significant improvement. Often, an attempt to cure at any cost is the result of a lack of established contact with the attending physician and failure to accept a serious diagnosis.
— Unfortunately, their efforts do not always bear fruit: in some cases, the therapeutic possibilities are exhausted, and additional treatment only harms. It is important for relatives to adequately assess the condition of their relative, to understand which treatment is still possible, and which will only worsen the quality of life," the expert explained.
Competent psychological support can help you accept the diagnosis and the situation itself, adapt to the disease and give the patient careful care, while preserving yourself, Anastasia Goltsman emphasized.
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