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Vuodeosastojen lakkautukset vaikuttavat saattohoitoon, jota laki ei vieläkään suojele | Kotimaa | Yle

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href="https://web.archive.org/web/20240503073134/https://yle.fi/t/18-216363/fi" aria-label="Lisää artikkeleita aiheesta Terveydenhuolto" class="TagLinkstyles__TagLinkBase-sc-w5hh4y-0 doqXHU">Terveydenhuolto</a></div><h1 class="sc-beySPh kuTmyG yle__article__heading yle__article__heading--1">Vuodeosastojen lakkautukset vaikuttavat saattohoitoon, jota laki ei vieläkään suojele</h1><p class="aw-1gybjub aw-5vja16 dvotnq YVZwc yle__article__paragraph">Viimeisiä päiviään elävä tarvitsee läheisensä lähelle. Ylä-Lapissa he voivat olla 200 kilometrin päässä kotoaan sen jälkeen, kun vuodeosastoja lakkautetaan säästötoimena.</p><div class="aw-e30oo3 fPIfav"></div><figure class="aw-u5oz0a eiswpX yle__article__figure"><script type="application/ld+json">{"@id":"74-20086740","@context":"https://web.archive.org/web/20240503073134/https://schema.org","video":{"@type":"VideoObject","description":"Utsjoella asuva ja Pohjois-Suomen syöpäyhdistyksen paikallisosastoa johtava Aarne Sujala pitää hyvin ikävänä tietoa terveyskeskuksen vuodeosaston sulkemisesta Utsjoella.","name":"Utsjokelaisten lähin vuodeosasto pian Ivalossa","thumbnailUrl":"https://web.archive.org/web/20240503073134/https://images.cdn.yle.fi/image/upload/ar_1.7777777777777777,c_fill,g_faces,h_431,w_767/dpr_2.0/q_auto:eco/f_auto/fl_lossy/39-42973859c268d07fd2f","uploadDate":"2024-05-02T16:04:00+03:00"}}</script><div class="aw-1a00tic glCyMm"><div><div data-testid="video-player" class="aw-1kfkhk6 kfQeIY"></div></div></div><figcaption class="aw-kr26k0 gwXnFP"><span>Utsjoella asuva ja Pohjois-Suomen syöpäyhdistyksen paikallisosastoa johtava Aarne Sujala pitää hyvin ikävänä tietoa terveyskeskuksen vuodeosaston sulkemisesta Utsjoella.</span></figcaption></figure><div class="aw-1wk2icm cLQuDx"><div class="aw-qww0lc bXDRBg"><div class="aw-x5rn7a cuuZMC"><span class="aw-z7z0zi jvmail">Annu Passoja</span></div></div></div><div class="aw-1hwlbbb dUitsS"><div class="aw-kzjed4 hdUrXi yle__article__date"><time class="aw-lsqctp iTvOCQ yle__article__date--published" datetime="2024-05-03T10:01:43+03:00">10:01</time></div></div></header><section class="yle__article__content"><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Kuolema lähellä omaisia käy mahdottomaksi osalle suomalaisista, kun terveyskeskusten vuodeosastoja suljetaan maaseutukunnissa.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Lapissa suljetaan säästösyistä esimerkiksi Utsjoen vuodeosasto. Lähin vuodeosasto on sen jälkeen Ivalossa, jonne on 160 kilometrin matka Utsjoen kirkonkylältä.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">– Viimeiset hetket ovat hyvin tärkeitä, juuri silloin ihminen tarvitsee läheisiä. Mutta onhan se aivan mahdotonta lähteä päivittäin 160 kilometrin päähän ja Nuorgamista matkaa on vielä enemmän. Näen tämän erittäin huonona, sanoo utsjokelainen <strong class="aw-ak79eh fyQnLO yle__article__strong">Aarne Sujala</strong>.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Syöpäyhdistyksen paikallisosastoa johtava Sujala kertoo, että suunnitelmat ovat puhuttaneet ja herättäneet huolta utsjokelaisissa.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Vuodeosastojen lakkautus seitsemässä kunnassa on osa Lapin hyvinvointialueen liki <a class="aw-iao6s4 fAvgdO yle__article__link" href="https://web.archive.org/web/20240503073134/https://yle.fi/a/74-20084404" role="link">sadan miljoonan euron säästöurakkaa.</a> Samanlaisia suunnitelmia on muuallakin. Välimatkat ovat kuitenkin Lapissa omaa luokkaansa.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Palliatiivisen lääketieteen yhdistystä johtava vaasalaislääkäri <strong class="aw-ak79eh fyQnLO yle__article__strong">Heidi Bengts</strong> pitää pitkäksi venyvää välimatkaa hyvin harmillisena.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">– Omaisilla täytyy ainakin olla mahdollisuus yöpyä osastolla potilaan kanssa, Bengts toteaa.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Kaikkein tärkeimpänä hän kuitenkin pitää hyvää hoitoa ja riittävää osaamista, vaikka matka sen äärelle olisi pidempi. Jotkut joutuvat kuoleman kynnyksellä yhä kärsimään oireista, jotka olisivat hoidettavissa.</p><h2 class="sc-guDLey kEXXRR yle__article__heading yle__article__heading--2">Yöllä apu tulee ambulanssilla</h2><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Oma koti olisi useimmille mieluisin paikka kuolla. Toiveen toteutuminen edellyttää kotisairaalan lisäksi omaisten sitoutumista. Jonkun täytyy olla vierellä koko ajan.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Kotisairaaloita toimii tällä hetkellä yhdessätoista Lapin kunnassa. Sellainen aiotaan perustaa kaikkiin muihinkin Lapin kuntiin vuoden sisällä, ja joka tapauksessa ennen kuin vuodeosasto suljetaan.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Sairaanhoitaja on saatavissa kotikäynnille aamusta iltaan, mutta ei yöllä. Silloin apuun on hälytettävä ensihoito, kertoo terveysjohtaja <strong class="aw-ak79eh fyQnLO yle__article__strong">Miia Palo</strong> Lapin hyvinvointialueen suunnitelmista.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">– Kotisairaalan kehittämisellä sekä yhteistyöllä ensihoidon ja palveluasumisen kanssa yritämme minimoida tilanteet, että ihminen joutuu lähtemään naapurikunnan vuodeosastolle tai vielä kauemmaksi. Mutta niitäkin tilanteita tulee, Palo toteaa.</p><figure class="aw-u5oz0a OjLHE yle__article__figure"><script type="application/ld+json">{"@id":"74-20086740","@context":"https://web.archive.org/web/20240503073134/https://schema.org","image":{"@type":"ImageObject","description":"Lapin hyvinvointialueen terveysjohtaja Miia Palo kertoo, että Lapissa tavoitteena olisi yksi tai kaksi hoitopaikkaa vaikeita saattohoitoja varten. Muuten saattohoito tapahtuisi kotisairaalan avulla kotona tai terveyskeskuksen vuodeosastolla tai hoivakodissa.","copyrightHolder":"Juuso Stoor / Yle","url":"https://web.archive.org/web/20240503073134/https://images.cdn.yle.fi/image/upload/ar_1.5001390047261607,c_fill,g_faces,h_511,w_767/dpr_2.0/q_auto:eco/f_auto/fl_lossy/39-1272659662103d401032","keywords":"Lapin hyvinvointialue,Lappi,lehdistötilaisuudet,hyvinvointialueet,sosiaali- ja terveysalueet,sote-uudistus,sosiaalipalvelut"}}</script><div class="aw-1a00tic iVeZI"><div class="aw-1qvmjke iZSzNK"><div class="aw-1njknqq jaRXHA"><picture><source data-testid="source-for-S" media="(max-width: 767px)" srcset="https://web.archive.org/web/20240503073134im_/https://images.cdn.yle.fi/image/upload/ar_1.5001390047261607,c_fill,g_faces,h_511,w_767/dpr_2.0/q_auto:eco/f_auto/fl_lossy/v1713439941/39-1272659662103d401032 2x, https://web.archive.org/web/20240503073134im_/https://images.cdn.yle.fi/image/upload/ar_1.5001390047261607,c_fill,g_faces,h_511,w_767/dpr_1.0/q_auto:eco/f_auto/fl_lossy/v1713439941/39-1272659662103d401032 1x"/><source data-testid="source-for-M" media="(min-width: 768px)" srcset="https://web.archive.org/web/20240503073134im_/https://images.cdn.yle.fi/image/upload/ar_1.5001390047261607,c_fill,g_faces,h_423,w_636/dpr_2.0/q_auto:eco/f_auto/fl_lossy/v1713439941/39-1272659662103d401032 2x, https://web.archive.org/web/20240503073134im_/https://images.cdn.yle.fi/image/upload/ar_1.5001390047261607,c_fill,g_faces,h_423,w_636/dpr_1.0/q_auto:eco/f_auto/fl_lossy/v1713439941/39-1272659662103d401032 1x"/><img alt="Nainen istuu koneellansa ja puhuu." src="https://web.archive.org/web/20240503073134im_/https://images.cdn.yle.fi/image/upload/c_crop,h_3034,w_5395,x_0,y_82/ar_1.7777777777777777,c_fill,g_faces,h_431,w_767/dpr_1.0/q_auto:eco/f_auto/fl_lossy/v1713439941/39-1272659662103d401032" class="aw-1l9m598 kDMeTj"/></picture></div><div class="aw-45s348 rjAqP"><button aria-disabled="false" class="Buttonstyles__ButtonBase-sc-17sr1bx-0 Buttonstyles__ButtonSecondary-sc-17sr1bx-2 kVAHoB jUvsxe"><span class="Buttonstyles__TextWrapper-sc-17sr1bx-7 fTwJAM yds-button__content">Avaa kuvien katselu</span></button></div></div></div><figcaption class="aw-kr26k0 gwXnFP"><span>Lapin hyvinvointialueen terveysjohtaja Miia Palo kertoo, että Lapissa tavoitteena olisi yksi tai kaksi hoitopaikkaa vaikeita saattohoitoja varten. Muuten saattohoito tapahtuisi kotisairaalan avulla kotona tai terveyskeskuksen vuodeosastolla tai hoivakodissa.</span><span> Kuva: Juuso Stoor / Yle</span></figcaption></figure><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Isoissa kaupungeissa kotisairaala toimii vuorokauden ympäri, mutta moniin pienempiin kuntiin tällaista palvelua ei saada koskaan.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Palliatiivisia potilaita hoitava syöpälääkäri Heidi Bengts korostaa, että hyvässä saattohoidossa voinnin heikkeneminen ennakoidaan lääkityksessä ja hoitotoimenpiteissä niin, että äkkikäänteitä ei tulisi.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">– Mutta yllätyksiä aina sattuu ja voi tulla tilanne, jota ei osattu ennakoida. Silloin täytyy olla joku taho, johon saa yhteyden ja ensihoito on ilman muuta parempi kuin ei mitään.</p><div class="aw-1w9qbp1 dBZsme"><div class="aw-1ucwf6p emNtij"><div class="aw-1njknqq jaRXHA"><picture><source data-testid="source-for-S" media="(max-width: 767px)" srcset="https://web.archive.org/web/20240503073134im_/https://images.cdn.yle.fi/image/upload/c_crop,h_4101,w_2734,x_1860,y_0/ar_0.6666666666666666,c_fill,g_faces,h_1150,w_767/dpr_2.0/q_auto:eco/f_auto/fl_lossy/v1662543034/39-1004256631863b549188 2x, https://web.archive.org/web/20240503073134im_/https://images.cdn.yle.fi/image/upload/c_crop,h_4101,w_2734,x_1860,y_0/ar_0.6666666666666666,c_fill,g_faces,h_1150,w_767/dpr_1.0/q_auto:eco/f_auto/fl_lossy/v1662543034/39-1004256631863b549188 1x"/><source data-testid="source-for-M" media="(min-width: 768px)" srcset="https://web.archive.org/web/20240503073134im_/https://images.cdn.yle.fi/image/upload/c_crop,h_3459,w_6151,x_1,y_0/ar_1.7777777777777777,c_fill,g_faces,h_357,w_636/dpr_2.0/q_auto:eco/f_auto/fl_lossy/v1662543034/39-1004256631863b549188 2x, https://web.archive.org/web/20240503073134im_/https://images.cdn.yle.fi/image/upload/c_crop,h_3459,w_6151,x_1,y_0/ar_1.7777777777777777,c_fill,g_faces,h_357,w_636/dpr_1.0/q_auto:eco/f_auto/fl_lossy/v1662543034/39-1004256631863b549188 1x"/><img alt="Siun työterveyden tyhjä käytävä." src="https://web.archive.org/web/20240503073134im_/https://images.cdn.yle.fi/image/upload/c_crop,h_3459,w_6151,x_1,y_0/ar_1.7777777777777777,c_fill,g_faces,h_431,w_767/dpr_1.0/q_auto:eco/f_auto/fl_lossy/v1662543034/39-1004256631863b549188" class="aw-ml7zab btxxie"/></picture></div></div><div class="aw-10p621g fFeJbD"><div class="aw-1ed5hyt bPSSxT scrollover-content"><div class="aw-1rer6np eDVZDf"><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Pohjois-Karjalassa ensihoito on turvannut kotona olevien saattohoitopotilaiden öitä jo vuosien ajan, ja kuolema kotona on yhä useammalle mahdollinen.</p></div></div></div></div><h2 class="sc-guDLey kEXXRR yle__article__heading yle__article__heading--2">Nuorikin voi kuolla hoivakodissa</h2><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Kuolemaa lähestyvällä olisi lupapaikka lähimmän vuodeosaston lisäksi myös paikkakunnalle jäävässä hoivakodissa. Lupapaikalle pääsee, jos saattohoito ei kotona enää syystä tai toisesta onnistu.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Hoivakodissa saisi hoivaa iästä riippumatta. Varsinaisesta sairaanhoidosta vastaisi yhä kotisairaala.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">– Hoivakoti ei ehkä ole mukavin ympäristö, jos potilas on nuori, mutta toisaalta niissä on kuitenkin omat huoneet. Tämä olisi jonkinlainen tapa mahdollistaa se, että voi olla lähempänä kotia, Bengts arvioi Lapin suunnitelmia.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Muualta Suomesta ei ole kantautunut Bengtsin korviin vastaavia suunnitelmia.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Sairaanhoitajia edustavan Suomen palliatiivisen hoidon yhdistyksen puheenjohtajaa <strong class="aw-ak79eh fyQnLO yle__article__strong">Mira Pajusta</strong> askarruttaa yhtälö, jossa hoivakotien vastuuta saattohoidossa lisätään samalla kun esimerkiksi hoitajamitoitusta kevennetään.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">– Henkilöstöresurssien ja saattohoidon osaamisen turvaaminen on keskeinen asia, se täytyy varmistaa, Pajunen painottaa.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Vaikeimmissa oireissa saattohoito edellyttää joka tapauksessa sairaalaosastoa.</p><div class="aw-1w9qbp1 dBZsme"><div class="aw-1ucwf6p emNtij"><div class="aw-1njknqq jaRXHA"><picture><source data-testid="source-for-S" media="(max-width: 767px)" srcset="https://web.archive.org/web/20240503073134im_/https://images.cdn.yle.fi/image/upload/c_crop,h_1080,w_720,x_828,y_0/ar_0.6666666666666666,c_fill,g_faces,h_1150,w_767/dpr_2.0/q_auto:eco/f_auto/fl_lossy/v1549286045/39-4660035a8c1c69b1840 2x, https://web.archive.org/web/20240503073134im_/https://images.cdn.yle.fi/image/upload/c_crop,h_1080,w_720,x_828,y_0/ar_0.6666666666666666,c_fill,g_faces,h_1150,w_767/dpr_1.0/q_auto:eco/f_auto/fl_lossy/v1549286045/39-4660035a8c1c69b1840 1x"/><source data-testid="source-for-M" media="(min-width: 768px)" srcset="https://web.archive.org/web/20240503073134im_/https://images.cdn.yle.fi/image/upload/c_crop,h_1080,w_1920,x_0,y_0/ar_1.7777777777777777,c_fill,g_faces,h_357,w_636/dpr_2.0/q_auto:eco/f_auto/fl_lossy/v1549286045/39-4660035a8c1c69b1840 2x, https://web.archive.org/web/20240503073134im_/https://images.cdn.yle.fi/image/upload/c_crop,h_1080,w_1920,x_0,y_0/ar_1.7777777777777777,c_fill,g_faces,h_357,w_636/dpr_1.0/q_auto:eco/f_auto/fl_lossy/v1549286045/39-4660035a8c1c69b1840 1x"/><img alt="Ikääntyvä nainen koskettaa puolisonsa kättä." src="https://web.archive.org/web/20240503073134im_/https://images.cdn.yle.fi/image/upload/c_crop,h_1080,w_1920,x_0,y_0/ar_1.7777777777777777,c_fill,g_faces,h_431,w_767/dpr_1.0/q_auto:eco/f_auto/fl_lossy/v1549286045/39-4660035a8c1c69b1840" class="aw-ml7zab btxxie"/></picture></div></div><div class="aw-10p621g fFeJbD"><div class="aw-1ed5hyt bPSSxT scrollover-content"><div class="aw-1rer6np eDVZDf"><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Elämän viimeisten viikkojen hoitoa on viime vuosina parannettu. Oikeutta saattohoitoon ei kuitenkaan ole vielä kirjattu lakiin.</p></div></div></div></div><h2 class="sc-guDLey kEXXRR yle__article__heading yle__article__heading--2">Saattohoito yhä ilman lain suojaa</h2><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Elämän loppuvaiheen hoitoon on satsattu viime vuosina monin tavoin: hoitajia on koulutettu ja kotisairaaloita perustettu. Keskussairaaloissa toimii palliatiivisia yksiköitä.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Bengts ja Pajunen toteavat saattohoidon olevan kuitenkin alttiina leikkauksille niin kauan, kun<a class="aw-iao6s4 fAvgdO yle__article__link" href="https://web.archive.org/web/20240503073134/https://www.sttinfo.fi/tiedote/69971095/suomen-palliatiivisen-laaketieteen-yhdistys-ilmaisee-huolensa-tamanhetkisesta-palliatiivisen-hoidon-ja-saattoh" role="link"> sitä ei laki suojaa</a>.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Hallitusohjelmassa kyllä luvataan ”selkeyttää säädöksin oikeutta saattohoitoon, joka turvaa hyvän elämän loppuvaiheen hoidon” asuinpaikasta tai hoitopaikasta riippumatta.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">– Toistaiseksi asia ei ole edennyt ja siitä olemme huolestuneita, Bengts sanoo.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Asuinpaikka määrittää vielä paljon. Utsjoen Puksalan kylässä puolisonsa kanssa asuva 76-vuotias Aarne Sujala miettii, mikä on edessä, jos hoitoa tarvitaan ja vuodeosasto on parin tunnin ajomatkan päässä.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Sujaloiden tyttäristä lähin asuu yli 500 kilometrin päässä.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">– Lapset on jo alkaneet huolestua, että miten me täällä pärjäämme. Sanon vaan, että aika näyttää.</p></section><footer class="yle__article__footer"><h2 class="aw-zh6d69 hdCyAB">Aiheesta enemmän: Paketissa 2 linkkiä</h2><h2 class="sc-dmyCSP iEtwyZ yle__article__heading yle__article__heading--3" aria-hidden="true">Aiheesta enemmän</h2><div class="yle__article__links" role="list" aria-label="Aiheesta enemmän"><div role="listitem" class="aw-124ec9l ccYNFu"><div class="aw-yq4wj5 kTECfb"><div class="aw-fou4nx eDDWtA"><div class="aw-aqrehu liOdKj"><div class="aw-ej1jxx dnbGnY"><a href="https://web.archive.org/web/20240503073134/https://yle.fi/t/18-209306/fi" aria-label="Lisää artikkeleita aiheesta Terveys" class="TagLinkstyles__TagLinkBase-sc-w5hh4y-0 doqXHU">Terveys</a></div><h3 class="aw-x9ikft gKAydi"><a href="https://web.archive.org/web/20240503073134/https://yle.fi/a/74-20079925" class="aw-3ocnud eJwoQw">Kuoleman hetki on edelleen tabu: tässä jutussa kolme näkökulmaa herkkään aiheeseen</a></h3><time class="aw-4gocmc hhtIWQ">1.4.</time></div></div><div class="aw-vhyz8i jrvFbe"><div class="aw-8sjfvz ddkLIr"><div class="aw-1njknqq jaRXHA"><picture><source data-testid="source-for-S" media="(max-width: 767px)" srcset="https://web.archive.org/web/20240503073134im_/https://images.cdn.yle.fi/image/upload/ar_1.0,c_fill,g_faces,h_104,w_104/dpr_2.0/q_auto:eco/f_auto/fl_lossy/39-126058465fbf82caf984 2x, https://web.archive.org/web/20240503073134im_/https://images.cdn.yle.fi/image/upload/ar_1.0,c_fill,g_faces,h_104,w_104/dpr_1.0/q_auto:eco/f_auto/fl_lossy/39-126058465fbf82caf984 1x"/><source data-testid="source-for-M" media="(min-width: 768px)" srcset="https://web.archive.org/web/20240503073134im_/https://images.cdn.yle.fi/image/upload/ar_1.7777777777777777,c_fill,g_faces,h_110,w_196/dpr_2.0/q_auto:eco/f_auto/fl_lossy/39-126058465fbf82caf984 2x, https://web.archive.org/web/20240503073134im_/https://images.cdn.yle.fi/image/upload/ar_1.7777777777777777,c_fill,g_faces,h_110,w_196/dpr_1.0/q_auto:eco/f_auto/fl_lossy/39-126058465fbf82caf984 1x"/><img alt="Emma von Weissenberg kitara kädessään. 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puolesta</a></h3><time class="aw-4gocmc hhtIWQ">2022</time></div></div><div class="aw-vhyz8i jrvFbe"><div class="aw-8sjfvz ddkLIr"><div class="aw-1njknqq jaRXHA"><picture><source data-testid="source-for-S" media="(max-width: 767px)" srcset="https://web.archive.org/web/20240503073134im_/https://images.cdn.yle.fi/image/upload/ar_1.0,c_fill,g_faces,h_104,w_104/dpr_2.0/q_auto:eco/f_auto/fl_lossy/39-1016415633be965b8a5c 2x, https://web.archive.org/web/20240503073134im_/https://images.cdn.yle.fi/image/upload/ar_1.0,c_fill,g_faces,h_104,w_104/dpr_1.0/q_auto:eco/f_auto/fl_lossy/39-1016415633be965b8a5c 1x"/><source data-testid="source-for-M" media="(min-width: 768px)" srcset="https://web.archive.org/web/20240503073134im_/https://images.cdn.yle.fi/image/upload/ar_1.7777777777777777,c_fill,g_faces,h_110,w_196/dpr_2.0/q_auto:eco/f_auto/fl_lossy/39-1016415633be965b8a5c 2x, 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Ylä-Lapissa he voivat olla 200 kilometrin päässä kotoaan sen jälkeen, kun vuodeosastoja lakkautetaan säästötoimena.","type":"text"},{"text":"Kuolema lähellä omaisia käy mahdottomaksi osalle suomalaisista, kun terveyskeskusten vuodeosastoja suljetaan maaseutukunnissa.","type":"text"},{"text":"Lapissa suljetaan säästösyistä esimerkiksi Utsjoen vuodeosasto. Lähin vuodeosasto on sen jälkeen Ivalossa, jonne on 160 kilometrin matka Utsjoen kirkonkylältä.","type":"text"},{"text":"– Viimeiset hetket ovat hyvin tärkeitä, juuri silloin ihminen tarvitsee läheisiä. Mutta onhan se aivan mahdotonta lähteä päivittäin 160 kilometrin päähän ja Nuorgamista matkaa on vielä enemmän. Näen tämän erittäin huonona, sanoo utsjokelainen **Aarne Sujala**.","type":"text"},{"text":"Syöpäyhdistyksen paikallisosastoa johtava Sujala kertoo, että suunnitelmat ovat puhuttaneet ja herättäneet huolta utsjokelaisissa.","type":"text"},{"text":"Vuodeosastojen lakkautus seitsemässä kunnassa on osa Lapin hyvinvointialueen liki [sadan miljoonan euron säästöurakkaa.](https:\u002F\u002Fyle.fi\u002Fa\u002F74-20084404) Samanlaisia suunnitelmia on muuallakin. Välimatkat ovat kuitenkin Lapissa omaa luokkaansa.","type":"text"},{"text":"Palliatiivisen lääketieteen yhdistystä johtava vaasalaislääkäri **Heidi Bengts** pitää pitkäksi venyvää välimatkaa hyvin harmillisena.","type":"text"},{"text":"– Omaisilla täytyy ainakin olla mahdollisuus yöpyä osastolla potilaan kanssa, Bengts toteaa.","type":"text"},{"text":"Kaikkein tärkeimpänä hän kuitenkin pitää hyvää hoitoa ja riittävää osaamista, vaikka matka sen äärelle olisi pidempi. Jotkut joutuvat kuoleman kynnyksellä yhä kärsimään oireista, jotka olisivat hoidettavissa.","type":"text"},{"text":"Yöllä apu tulee ambulanssilla","level":2,"type":"heading"},{"text":"Oma koti olisi useimmille mieluisin paikka kuolla. Toiveen toteutuminen edellyttää kotisairaalan lisäksi omaisten sitoutumista. Jonkun täytyy olla vierellä koko ajan.","type":"text"},{"text":"Kotisairaaloita toimii tällä hetkellä yhdessätoista Lapin kunnassa. Sellainen aiotaan perustaa kaikkiin muihinkin Lapin kuntiin vuoden sisällä, ja joka tapauksessa ennen kuin vuodeosasto suljetaan.","type":"text"},{"text":"Sairaanhoitaja on saatavissa kotikäynnille aamusta iltaan, mutta ei yöllä. Silloin apuun on hälytettävä ensihoito, kertoo terveysjohtaja **Miia Palo** Lapin hyvinvointialueen suunnitelmista.","type":"text"},{"text":"– Kotisairaalan kehittämisellä sekä yhteistyöllä ensihoidon ja palveluasumisen kanssa yritämme minimoida tilanteet, että ihminen joutuu lähtemään naapurikunnan vuodeosastolle tai vielä kauemmaksi. Mutta niitäkin tilanteita tulee, Palo toteaa.","type":"text"},{"displayStyle":"normal","alt":"Nainen istuu koneellansa ja puhuu.","source":"Juuso Stoor \u002F Yle","aspect":1.5001390047261607,"caption":"Lapin hyvinvointialueen terveysjohtaja Miia Palo kertoo, että Lapissa tavoitteena olisi yksi tai kaksi hoitopaikkaa vaikeita saattohoitoja varten. Muuten saattohoito tapahtuisi kotisairaalan avulla kotona tai terveyskeskuksen vuodeosastolla tai hoivakodissa.","id":"39-1272659662103d401032","type":"image","alts":[{"language":"fin","value":"Nainen istuu koneellansa ja puhuu."}],"blurhash":"LrLgz{~qNdaJ_N%MRjWBNGRjadoz","tags":[{"label":[{"language":"eng","value":"The wellbeing services county of Lapland"},{"language":"fin","value":"Lapin hyvinvointialue"},{"language":"swe","value":"Lapplands välfärdsområde"}],"extId":"18-333051"},{"label":[{"language":"eng","value":"Lapland Province"},{"language":"fin","value":"Lappi"},{"language":"sme","value":"Lappi"},{"language":"swe","value":"Lappland"}],"extId":"18-148152"},{"label":[{"language":"fin","value":"lehdistötilaisuudet"},{"language":"swe","value":"presskonferenser"}],"extId":"18-357645"},{"label":[{"language":"eng","value":"Wellbeing Services County"},{"language":"fin","value":"hyvinvointialueet"},{"language":"swe","value":"välfärdsområden"}],"extId":"18-327171"},{"label":[{"language":"fin","value":"sosiaali- ja terveysalueet"},{"language":"swe","value":"social- och hälsovårdsområden"}],"extId":"18-237227"},{"label":[{"language":"fin","value":"sote-uudistus"},{"language":"swe","value":"social- och hälsovårdsreformen (sote)"}],"extId":"18-35370"},{"label":[{"language":"eng","value":"social services"},{"language":"fin","value":"sosiaalipalvelut"},{"language":"swe","value":"sociala tjänster"}],"extId":"18-217060"}],"copyright":[{"language":"und","value":"Juuso Stoor \u002F Yle"}],"crops":[{"name":"16:9","aspect":1.78,"coordinates":{"x":0,"y":82,"width":5395,"height":3034}},{"name":"2:3","aspect":0.67,"coordinates":{"x":2023,"y":0,"width":2398,"height":3597}},{"name":"1:1","aspect":1,"coordinates":{"x":1686,"y":0,"width":3597,"height":3597}}],"height":3597,"licence":{"id":"6","name":[{"language":"und","value":"Yle"}],"properties":[]},"version":"1713439941","width":5396,"recommendedFormat":"jpg"},{"text":"Isoissa kaupungeissa kotisairaala toimii vuorokauden ympäri, mutta moniin pienempiin kuntiin tällaista palvelua ei saada koskaan.","type":"text"},{"text":"Palliatiivisia potilaita hoitava syöpälääkäri Heidi Bengts korostaa, että hyvässä saattohoidossa voinnin heikkeneminen ennakoidaan lääkityksessä ja hoitotoimenpiteissä niin, että äkkikäänteitä ei tulisi.","type":"text"},{"text":"– Mutta yllätyksiä aina sattuu ja voi tulla tilanne, jota ei osattu ennakoida. Silloin täytyy olla joku taho, johon saa yhteyden ja ensihoito on ilman muuta parempi kuin ei mitään.","type":"text"},{"pages":[{"content":[{"text":"Pohjois-Karjalassa ensihoito on turvannut kotona olevien saattohoitopotilaiden öitä jo vuosien ajan, ja kuolema kotona on yhä useammalle mahdollinen.","type":"text"}],"type":"scrollover-page","media":{"alt":"Siun työterveyden tyhjä käytävä.","source":"Heikki Haapalainen \u002F Yle","aspect":1,"id":"39-1004256631863b549188","type":"image","alts":[{"language":"fin","value":"Siun työterveyden tyhjä käytävä."}],"blurhash":"LJLX0q^hRh_4xuxHInIU8_x[xbS4","tags":[{"label":[{"language":"fin","value":"työterveys"},{"language":"swe","value":"arbetshälsa"}],"extId":"18-205477"},{"label":[{"language":"fin","value":"työterveyshuolto"},{"language":"swe","value":"företagshälsovård"}],"extId":"18-218159"},{"label":[{"language":"eng","value":"Occupational Health Centre"},{"language":"fin","value":"Työterveysasema"},{"language":"swe","value":"Företagshälsostation"}],"extId":"18-44217"},{"label":[{"language":"eng","value":"occupational health care"},{"language":"fin","value":"Työterveyshuolto"},{"language":"swe","value":"företagshälsovård"}],"extId":"18-337525"},{"label":[{"language":"eng","value":"North Karelia Central Hospital and Honkalampi Centre (PKSSK)"},{"language":"fin","value":"Pohjois-Karjalan sosiaali- ja terveyspalvelujen kuntayhtymä, Siun sote"},{"language":"swe","value":"Samkommunen för sjukvårds- och socialtjänster i Norra Karelen"}],"extId":"18-311714"}],"copyright":[{"language":"und","value":"Heikki Haapalainen \u002F Yle"}],"crops":[{"name":"16:9","aspect":1.78,"coordinates":{"x":1,"y":0,"width":6151,"height":3459}},{"name":"2:3","aspect":0.67,"coordinates":{"x":1860,"y":0,"width":2734,"height":4101}},{"name":"1:1","aspect":1,"coordinates":{"x":1001,"y":0,"width":4101,"height":4101}},{"name":"5:2","aspect":2.5,"coordinates":{"x":0,"y":1039,"width":6151,"height":2460}}],"height":4101,"licence":{"id":"6","name":[{"language":"und","value":"Yle"}],"properties":[]},"version":"1662543034","width":6152,"recommendedFormat":"jpg"}}],"type":"scrollover-pages"},{"text":"Nuorikin voi kuolla hoivakodissa","level":2,"type":"heading"},{"text":"Kuolemaa lähestyvällä olisi lupapaikka lähimmän vuodeosaston lisäksi myös paikkakunnalle jäävässä hoivakodissa. Lupapaikalle pääsee, jos saattohoito ei kotona enää syystä tai toisesta onnistu.","type":"text"},{"text":"Hoivakodissa saisi hoivaa iästä riippumatta. Varsinaisesta sairaanhoidosta vastaisi yhä kotisairaala.","type":"text"},{"text":"– Hoivakoti ei ehkä ole mukavin ympäristö, jos potilas on nuori, mutta toisaalta niissä on kuitenkin omat huoneet. Tämä olisi jonkinlainen tapa mahdollistaa se, että voi olla lähempänä kotia, Bengts arvioi Lapin suunnitelmia.","type":"text"},{"text":"Muualta Suomesta ei ole kantautunut Bengtsin korviin vastaavia suunnitelmia.","type":"text"},{"text":"Sairaanhoitajia edustavan Suomen palliatiivisen hoidon yhdistyksen puheenjohtajaa **Mira Pajusta** askarruttaa yhtälö, jossa hoivakotien vastuuta saattohoidossa lisätään samalla kun esimerkiksi hoitajamitoitusta kevennetään.","type":"text"},{"text":"– Henkilöstöresurssien ja saattohoidon osaamisen turvaaminen on keskeinen asia, se täytyy varmistaa, Pajunen painottaa.","type":"text"},{"text":"Vaikeimmissa oireissa saattohoito edellyttää joka tapauksessa sairaalaosastoa.","type":"text"},{"pages":[{"content":[{"text":"Elämän viimeisten viikkojen hoitoa on viime vuosina parannettu. 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Keskussairaaloissa toimii palliatiivisia yksiköitä.","type":"text"},{"text":"Bengts ja Pajunen toteavat saattohoidon olevan kuitenkin alttiina leikkauksille niin kauan, kun[ sitä ei laki suojaa](https:\u002F\u002Fwww.sttinfo.fi\u002Ftiedote\u002F69971095\u002Fsuomen-palliatiivisen-laaketieteen-yhdistys-ilmaisee-huolensa-tamanhetkisesta-palliatiivisen-hoidon-ja-saattoh).","type":"text"},{"text":"Hallitusohjelmassa kyllä luvataan ”selkeyttää säädöksin oikeutta saattohoitoon, joka turvaa hyvän elämän loppuvaiheen hoidon” asuinpaikasta tai hoitopaikasta riippumatta.","type":"text"},{"text":"– Toistaiseksi asia ei ole edennyt ja siitä olemme huolestuneita, Bengts sanoo.","type":"text"},{"text":"Asuinpaikka määrittää vielä paljon. Utsjoen Puksalan kylässä puolisonsa kanssa asuva 76-vuotias Aarne Sujala miettii, mikä on edessä, jos hoitoa tarvitaan ja vuodeosasto on parin tunnin ajomatkan päässä.","type":"text"},{"text":"Sujaloiden tyttäristä lähin asuu yli 500 kilometrin päässä.","type":"text"},{"text":"– Lapset on jo alkaneet huolestua, että miten me täällä pärjäämme. 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