Pal­lia­tive care and hos­pice care ser­vices in Wellbeing Services County of East Uusimaa

The palliative outpatient clinic operates in the premises of Porvoo Hospital on weekdays during office hours. Access to the clinic is by physician referral, primarily from HUS hospitals, especially the Cancer Center, but also from various outpatient clinics at Porvoo Hospital.

Patients visit the clinic when their condition still allows them to attend hospital appointments. At the clinic, the overall symptom management plan and follow-up are designed. Care is provided through appointments and follow-up calls. As the patient’s condition deteriorates, monitoring and treatment usually shift from the clinic to the home hospital.

The specialists at the palliative outpatient clinic also provide consultation support related to symptom management for various units within the hospital, primary healthcare, and social services. Professionals at the clinic are responsible for delivering specialized-level psychosocial support across the entire center.

The East Uusimaa regional home hospital provides hospital-level care at home or in assisted living facilities for residents of the area, around the clock, every day of the year. Home hospital care is delivered in the patient’s home, other living arrangements such as assisted living facilities, or on an outpatient basis at designated units.

The home hospital treats, among others, patients with infections or other acute illnesses requiring intravenous medication, hydration, or nutritional support. Blood transfusions and iron infusions can also be administered at home. The home hospital is responsible for palliative and end-of-life care in East Uusimaa and cares for the region’s palliative patients as well as those receiving home-based end-of-life care.

Admission to the home hospital is by physician referral. Patients are typically referred through urgent care and emergency departments, home care and nursing facility physicians, or inpatient wards. Successful home hospital care requires, among other things, the ability to treat the patient safely at home, the patient’s own willingness, and commitment to the treatment.

A-level support ward services are organized by the wellbeing area in connection with the inpatient wards of health center hospitals in East Uusimaa. Specialized-level palliative support ward services are provided on Ward 3 of the Internal Medicine Department at Porvoo Hospital, in collaboration between the ward and the Palliative Care Center. Care for Palliative Care Center patients in the support ward is arranged through the center according to the patient’s needs. Patients have access to inpatient wards around the clock whenever their treatment requires it.

Patients who meet the criteria for demanding special level care are referred, if they wish, to inpatient care at Terhokoti with a payment commitment granted by HUS.

LiiSa’s nurse performs care assessment visits for the elderly population within the region’s care network (care units and home care) when their condition changes acutely. LiiSa’s goal is to provide older people with quick and convenient nursing care in their assisted living unit and to protect them from burdensome transfers to the emergency department when their condition can be treated at home. LiiSa also supports the implementation of basic-level palliative care in the area.

LiiSa’s nurses carry out care assessment visits to patients’ homes, especially in assisted living facilities, when an elderly person’s condition requires evaluation by a healthcare professional. A LiiSa nurse is always requested by a professional—such as a nurse or physician from an assisted living unit, home care, or emergency department. The aim is to utilize the service network so that follow-up care can also be arranged without resorting to specialized emergency care.