RESOURSE CENTRE OF PALLIATIVE CARE ID ST.DIMITRY SISTERHOOD: EXPERIENCE AND INNOVATIONS
The resource centre of palliative care for PLHIV was created to elaborate and introduce educational programs. In co-operation with the AIDS Moscow City Centre of the Moscow Department for Healthcare.
The program includes modules aimed at target groups: sisters of mercy and volunteers of Orthodox sisterhoods, professors and students of medical colleges, medical nurses and doctors of general hospitals and AIDS-centres. The modules focus on teaching skills of professional nursing along with spiritual basics of Christian charity. For target groups of Orthodox sisters of mercy and volunteers the modules embrace more knowledge on routes of infections, development and nursing of the HIV-infection and nursing of patients with HIV clinical symptomatology. For target groups of doctors, medical nurses of state healthcare institutions the module includes the introduction of theological and ethical aspects of disease acceptance, Christian attitude towards life and death, stages of diagnosis acceptance. Conversations are conducted by a priest, answering questions on both patient care and shaping the outlook of doctors and nurses themselves.
25 training seminars on “Palliative care and nursing” were held from 2005 to 2010. In Moscow (6), Saint-Petersburg (2), Orenburg (4), Saratov (1), Nizhniy Novgorod (1), Volgograd (1), Arkhangelsk (1), Minsk (2), Mogilev (1), Kiev (1), Alupka (1), Tjumen (1), Ivanovo (1), Rostov-on-the-Don (1), Ekaterinburg (1). 44 Orthodox sisterhoods took part in the seminars. From Russia — (31), Belarus — (8), Ukraine — (5). Up to 2008 the seminars were held with the blessing of His Holiness Patriarch of Moscow and All Russia Alexi II. Then the blessing of His Holiness Patriarch of Moscow and All Russia Kirill was obtained. The seminars were supported and encouraged by the dioceses hierarchy, and organized by the local clergy in charge of medical and social activities in dioceses. Totally from 2005 to 2017 — 47 seminars were held, 1980 employees of church establishments and state medioprophilactic and educational institutions were trained.
In several regions of the Russian Federation, Moscow, Arkhangelsk, Orenburg, Ivanovo, Ekaterinburg, Saratov, Nizhniy Novgorod, Tjumen, the training seminars were organized with the assistance of local centres for HIV prevention and treatment. Joined efforts of the Resource Centre established by the Sisterhood and local AIDES-centres made the first step towards the interaction of state healthcare institutions and sisiterhoods of mercy in the palliative care sphere.
Medical-social case management of people living with HIV and their families.
For instance, in the Clinical infectious diseases hospital #2 on Sokolinaya Hill there are 4 departments for HIV patients and AIDES stage patients. In those departments 260 patients are treated, 50 of them with physical and psychological disabilities in need of intensive symptomatic therapy, psychosocial support and constant outside assistance. Patients receive therapies to cut short symptoms of the disease including anti-retrovirus therapy, paramedical personnel carry out nursing manipulations and procedures. However this care and attention is not enough for these gravely sick bed patients. They need shaving, hair-cutting, washing, changing linen, assistance with sanitary and hygienic procedures, and those can be done by both sisters of mercy and volunteers. In a better state are patients with relatives, mostly mothers, taking care of them. But by-turn, relatives and family members themselves need help and support. And this kind of assistance can be carried out as constant accompaniment of a patient and their family in hospital and after discharge from hospital. Through this help, the maintenance of PLHIV, backup of their active stand in life and sometimes, as out experience proves, life itself — is possible.
Saint Dimitry Sisterhood, being a social-oriented non-commercial organization, for 27 years has been administering medical, social, psychological and spiritual care to patients with chronic progressive diseases, it functions with the state license to implement medical care in the city of Moscow. The license is valid till 2012. The institution holds the potential for solving the above stated problem and for 3 years has already been administering care to HIV-patients in the Clinical infectious diseases hospital #2 on Sokolinaya Hill and in homes. The experiences aquired in the Clinical infectious diseases hospital #2 on Sokolinaya Hill and nursing skills have helped the Sisterhood to establish a new service in the HIV patients care sphere – that is palliative care and nursing. AIDES centres as well as public foundations working with terminally ill patients apply to our Resource Centre for informative, methodological and practical support. Our innovation is organizing palliative care with the assistance of volunteers trained within “the Volunteer Courses”, they take care of PLHIV in the Clinical infectious diseases hospital #2 on Sokolinaya Hill, in orphanages for disabled children #15 and #48, and in homes. Nursing trainings have been held for 72 sisterhoods in different regions of Russia, 12 of them have started working with PLHIV.
The Resource Centre have trained 700 specialists from 25 healthcare institutions in 22 regions in Russia, Belarus and Ukraine. Various models of social partnership of religious establishments and state healthcare institutions in the PLHIV care sphere have been described, tested and approved.