In the Russian page - The Article
by Dr E. Vvedenskaya 

Palliative Care Is a Modern Public Health Approach

Summary

An ageing population, a growing incidence and prevalence of cancer, and an emerging HIV/AIDS epidemic make a compelling argument for immediate attention to be given to palliative care in current health care system reform discussions. In early 80th the WHO announced about necessity of a new public health approach creation and has been applying great efforts for palliative care integration within the public health systems of different countries across the world. By 2002 WHO definition "palliative care is an approach which improves the quality of life of patients and their families facing life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychological and spiritual". This new public health approach has been developing in Russia since 1990 when the first hospice in St.-Petersburg was set up and now is gradually spreading in many regions.

What is palliative care?
A description of what is meant by the term palliative care, when and where it is provided and by whom. The Palliative Care Strategy defines palliative care as the specialised care of people who are dying. A person receiving palliative care will have an active, progressive and far-advanced disease, with little or no prospect of cure.
The aim of palliative care is to achieve the best possible quality of life, for both the person who is dying and for their carers and family.

Palliative care:
·                affirms life and regards dying as a normal process
·                neither hastens nor postpones death
·                provides relief from pain and other distressing symptoms
·                combines the physical, psychological, social, emotional and spiritual aspects of    care in a coordinated approach
·                helps people have a good quality of life for as long as possible until their death, and offers a support system to help the family cope during the person's illness, and in their own bereavement.
Who receives palliative care?
Palliative care is provided to people of all ages who are dying - from children to the elderly. The need for palliative care does not depend on any specific medical diagnosis, but on the person's needs. Some of the common medical conditions of people requiring palliative care include: cancer, HIV/AIDS, motor neuron disease, muscular dystrophy, multiple sclerosis and end-stage dementia.
Families and carers also receive the benefits of palliative care services. These people provide much of the care for patients who are dying, so practical and emotional support for them is critical. 
Where are palliative care services provided?
Outlines the settings and places where palliative care is provided.
Palliative care services can be provided in the home, in community-based settings like nursing homes, palliative care units, and in hospitals. People who are dying need to be able to move freely between these places, in response to their medical care and support needs. The pattern of care will be different for every individual, and may depend on factors like: geography, services in the area, and the needs and desires of the person, their family members and friends. In general, palliative care is best provided within close proximity to the person's local environment and community. 
Who provides palliative care services?
Outlines the range of people and groups who are involved in the provision of palliative care. The needs of people who are dying and their families cross the physical, emotional and spiritual domains. Care and support is required which coordinates the skills and disciplines of many service providers. People involved in palliative care may include:
·                medical practitioners, including general practitioners, palliative care specialists, and other specialist physicians with a related interest
·                nurses, including generalist and specialist nurses in the community, hospital and inpatient palliative care settings, and independent nurse practitioners
·                allied health professionals, including social workers, physiotherapists, occupational therapists, psychologists, pharmacists, dietitians and speech pathologists
·                volunteers
·                support workers, including nurse assistants, personal care attendants and diversional therapists
·                bereavement counsellors
·                spiritual carers from a range of pastoral, spiritual and cultural backgrounds
·                professionals with language skills and cultural knowledge of ethnic groups
·                therapists skilled in music, massage, aromatherapy, or colour.
Administrators or business managers provide essential support to the team.
Beyond the palliative care team, a number of other services may help to support people who are dying and their families in, for example, areas such as financial planning, legal issues, and funerals.
Families, as well as receiving care from the palliative care team, are themselves critical members of the team. In particular, where a person is cared for at home, the family usually provides a large proportion of the hands-on care.