Pal­lia­tive care and hos­pice care ser­vices in the Well­being Ser­vices Coun­ty of Kanta-Häme

The palliative outpatient clinic provides physician and nurse appointments, telephone contacts, and consultations every weekday during office hours. Remote appointments are also possible. The clinic is staffed by one physician–nurse pair.

Patients followed by the palliative outpatient clinic attend appointments as needed. Between visits, patients are contacted by phone. When the patient’s condition deteriorates and the need for support increases, responsibility for palliative care is transferred to the home hospital.

Through the outpatient clinic, necessary palliative procedures or examinations are arranged for palliative patients. For these, the patient may be admitted to the day hospital or to a palliative intervention bed on the central hospital’s inpatient ward.

A consultation team consisting of a physician and a nurse visits the central hospital’s wards and emergency department upon request. During inpatient consultations, the team provides recommendations for symptom‑relieving medications, plans further care, and participates in care conferences together with the treating specialty when needed. The consultation team also supports the implementation of end‑of‑life care on the wards.

Patients receiving palliative care and their families are supported by the hospital’s multidisciplinary team, which includes a psychologist, a psychiatric nurse, a social worker, and hospital chaplains. In challenging situations, a psychotherapist from Koivikko Home is available. Patients and their families may also be referred to the services of the Cancer Society of Southern Finland.

The operations of the Kanta‑Häme home hospital cover the entire wellbeing services county, with three units located in Hämeenlinna, Riihimäki, and Forssa. Admission to the home hospital requires a physician’s referral. It provides palliative care and end‑of‑life care services in the patient’s home or in a residential care facility. Nurses work morning and evening shifts, while physicians are available during office hours. Night‑time care is supported by the mobile unit GerBiili, operated jointly by the home hospital and emergency medical services, and night‑time calls are directed there.

For palliative home hospital patients, a designated support ward is agreed upon based on care needs. The patient can be transferred there directly from home if symptoms can no longer be managed at home despite the support of the home hospital.

For home hospital patients, a designated basic‑level support ward is always agreed upon within the primary healthcare hospital of their area: Vanajavesi Hospital, Riihimäki Hospital, Forssa Hospital, or Janakkala Hospital.

Patients requiring specialized‑level inpatient care are directed to Koivikko Home, a 13‑bed unit located in Hämeenlinna, which also serves as a support ward for the home hospital. All staff members at Koivikko Home are specially trained in palliative care and end‑of‑life care. In addition to physicians and nurses, Koivikko Home employs a psychotherapist, a hospital chaplain, and volunteers.

A patient in need of palliative care who is currently on a central hospital inpatient ward is usually transferred to a dedicated palliative/end‑of‑life care ward for continued care whenever possible. If the patient’s condition does not allow transfer, the palliative consultation team supports the implementation of high‑quality end‑of‑life care on the specialized healthcare ward.