Editing Palliative care (section)

== 1. Contribution to the health system ==

For people with life-threatening conditions such as those in palliative care, the healthcare system must and should focus not only on stabilizing the medical condition but also on alleviating symptoms, pain and stress of serious illness and providing support to family members. In addition to the above, participants at the primary health care level actively participate in the coordination and organization of the provision of services in the user’s home. The health status of people in palliative care can change significantly over a shorter or longer period. The integration of healthcare ensures that services are adapted to these changes, whether they require more intensive medical care or adjustments to the care plan. In short, the integration of healthcare into long-term care services provides comprehensive, continuous and coordinated care that meets the multiple needs of individuals, improving their quality of life and health outcomes with a positive organizational and financial impact on the health system.

Healthcare participates in the provision of palliative care according to the stage of progression of the patient’s illness through three forms. The first form is the provision of healthcare to people with disabilities or chronic illnesses where there are no significant changes. Such persons require specific or enhanced healthcare. The second group includes people who have developed a serious illness with a certain progression and change in needs. The third group consists of people who have social problems or difficulties related to activities of daily living, and their healthcare is specific because it cannot be provided in the usual way or place. Therefore, the degree of progression of the health condition is closely related to social factors, which ultimately affect the final outcome of care.

Through the working models it applies, the Health Promotion Center aims to raise awareness among counseling users, as well as the wider community, about the importance of a healthy lifestyle in promoting health and preventing and controlling not only obesity but also other chronic diseases and conditions. It strives to increase users’ knowledge of the principles of proper nutrition and health-oriented physical activity, as well as knowledge of risk factors for heart and vascular diseases, as well as for diabetes, cancer, etc. Through the different types of support it provides, it strives to motivate people with unhealthy lifestyles to make positive changes. The counseling center applies an individual approach and group counseling. Thus, there is the possibility of individual counseling with a doctor, nutritionist and psychologist, performing anthropometric measurements with an analysis of body composition on a medical scale and creating a diet plan and menu. The counseling center is open on Mondays, Tuesdays, Wednesdays and Fridays from 7 a.m. to 3 p.m., and on Thursdays from 7 a.m. to 8 p.m. The services are free of charge and a referral from a chosen doctor is not required. Interested parties can make an appointment by phone, e-mail or by coming to the premises of the Institute’s Department of Public Health and Health Promotion.

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=== 1.1. General and specific needs for medical interventions and health services ===

Different groups of users need different types of medical interventions and health services. Based on the previous classification into three groups according to the progression of the patient’s illness, we can define the framework of necessary services adapted to functional abilities, i.e. the person’s capabilities. The first group includes immobile or poorly mobile persons who, depending on the stage of disease progression, depend on medical technologies or aids, such as oxygen therapy, hemodialysis, or regular interventions to maintain their current condition. The second group consists of people who have partially recovered from acute exacerbations, but are on the path of further exacerbations (acute and chronic). These are people after a stroke, people with neurological diseases or people with the progression of malignant diseases, i.e. patients in palliative care, where it is necessary to continuously adapt healthcare to changing needs. The third group consists of people who have problems with performing daily activities independently (e.g. self-care, normal social functioning), such as people with intellectual disabilities, very old and frail people, etc. Healthcare for them must first and foremost be adapted to these specific circumstances.

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