Pal­lia­tive care and hos­pice care ser­vices in the wellbeing services county of South Karelia

The ward operates at the Armila Rehabilitation Centre. It has 12 patient beds and 2 additional beds when needed. At the ward, patients receiving palliative care or end-of-life care are treated. As a rule, patients are admitted for continued care from various units of South Karelia Central Hospital through the SAS office, or with a referral from the palliative outpatient clinic. The ward also serves as a support unit for home hospital patients in the final stage of life; admissions in these cases are based on an assessment made by the home hospital. A ward physician with specialist competence in palliative care is responsible for the medical activities of the unit. In addition to physicians and nursing staff, team includes a physiotherapist, occupational therapist, hospital chaplain, and social worker. Support persons from the Saimaa Cancer Society are also available to support patients and their families when needed.

The ward functions as a special level palliative care unit and end-of-life care unit within the South Karelia wellbeing services area. The task is to ensure high-quality symptom-relieving care and good quality of life for patients receiving palliative or end-of-life care. Family members are an important part of a patient’s care. Treatment based on an individual palliative care plan is provided. Respect for the patient and their loved ones, autonomy, safety, and supporting the patient’s functional ability are emphasised in the care.

In connection with the palliative ward, a palliative outpatient clinic operates from Monday to Friday during office hours, providing reception and consultation services. The physician holds appointments 1–2 times per week. A nurse also sees patients and is available by phone. Home visits are made when necessary.

Patients are referred to the outpatient clinic by their responsible physician once a palliative care pathway or end-of-life care plan has been established.

During the appointment, a comprehensive palliative care plan is prepared together with the patient and their loved ones. The need for symptom relief (pain and other distressing symptoms) as well as the need for psychosocial support is assessed. Support measures are planned and coordinated according to the patient’s individual needs. During the visit, a support ward that can provide care at the end of life is also determined. The coping and support needs of the patient’s family members are also taken into consideration.

The home hospital provides hospital-level care delivered at home. The South Karelia Home Hospital consists of mobile single‑person on‑call units as well as non-urgent enhanced home nursing. The Home Hospital’s operations in the South Karelia region are provided from four units between 8:00 and 20:00: Imatra, Lappeenranta, Savitaipale, and Parikkala. During the night, services are provided by the Imatra and Lappeenranta units.

Home hospital care is provided in the patient’s home or place of residence in collaboration with various actors, such as home care services. Palliative home hospital care enables safe, high-quality, and individualised care for patients with incurable illnesses in the final stage of life. It also allows for end‑of‑life care to be provided at home.

The Home Hospital is equipped to deliver planned symptom management and to respond quickly to changing situations. With Home Hospital services, inpatient care can be avoided or shortened according to the patient’s wishes, provided a healthcare professional considers it feasible. A patient may be transferred to the Home Hospital directly from units within the wellbeing services county.

• Kotisairaala (ekhva.fi, in Finnish)