Transportation of elderly people. Intercity and international transportation of patients from city to city in Russia, Europe and abroad How to transport a disabled person to another city
Tell the young man that he will be moving to another area or city. He will experience joyful excitement from meeting a new life and upcoming changes. Tell the same news to an elderly person - elderly parents or other older relatives - and you will most likely see concern in their eyes. Not surprising: older people see only risks in this situation - a critical way out of their comfort zone.
Well where will I go
Almost 13 years ago, my parents, in order to be closer to their son and daughter living in the capital, decided to move from a closed military town 80 km from Moscow to a closer settlement. They worked in the town for 36 years: mother as a school teacher, father in a military unit. All this time they were restricted from traveling abroad, which earned them the right to move under the state program closer to their grown children. My father was 69 then, and my mother was 67 years old.
The first acquaintance with the new apartment, which the state gave, was, on the whole, pleasing: the six-story building was surrounded by greenery, the heating and water supply worked properly (in the town - intermittently) and the fifth floor without an elevator was not scary at that time. We moved almost all of their furniture, since at this age the parents did not want to change the situation.
Everyday life after the move revealed a lot of difficulties. The store and the nearest bus stop were a 10-minute walk away, the clinic was a 15-minute drive away. There was no pharmacy, Sberbank or post office nearby. The climb to the fifth floor became more and more difficult for the parents every year - they increasingly complained of weakness in the legs, a “popping out” heart and shortness of breath.
In addition, respected people in the town, who knew everyone and whom everyone knew, were left here completely without a social circle - calling old friends and acquaintances turned out to be expensive, and it was impossible to make new acquaintances: the other two apartments on the floor were rented out, the neighbors were constantly changing, the house actually had no yard where you could walk and socialize.
Sometimes sick parents did not leave the apartment for days, even to buy groceries: they could not imagine how they would go up to the 5th floor with bread and milk. Not to mention getting to the post office to pay the rent. In such cases, they waited for the weekend when my brother or I would arrive.
The only thing that saved us was a dacha not far from our previous place of residence, where we took our parents from April to October. There they again found themselves in a familiar comfortable environment - they were surrounded by long-familiar faces, they did not have to go up to the 5th floor, and there was always something to do in the vegetable garden, flower garden and garden. After moving, dad suffered two heart attacks, and three years ago he passed away. Mom is now almost 80 years old and when she comes home from the dacha, she can barely get up to her 5th floor. She doesn’t agree to move in with me or her brother - like many people her age, she doesn’t want to interfere or be a burden.
Don't move until the last minute
Children often become angry with their aging parents when they refuse to move closer to them. But are they right?
According to Alexey Sidnev, the head of the Russian group of companies Senior Group, specializing in comprehensive care for older people, the best thing you can do is not to move.
“You should not move if possible, since this is a huge stress for older people - it is better to maintain a comfortable environment for your elderly relatives and provide them with the necessary help or care at home,” says the expert.
(It seems that our family, with the best of intentions, made a mistake by not thinking about the possible future problems of our parents. Although, according to psychologists, when older people themselves made the decision to move, they understand the consequences and adapt more easily.)
Make your move smooth
But what to do if moving to an institution or other place of residence for older people is inevitable? In Moscow and the Moscow region, Senior Group has seven institutions for the elderly; this experience allowed us to develop our own rules. The move must be carefully prepared.
As Alexey Sidnev says, first of all, the move must be made smooth. That is, on the one hand, to familiarize a person as much as possible with the conditions in which he will find himself and with his future environment. If this is a nursing home, then the staff should also find out as much as possible about the new ward in advance.
“In our case, the nurse who will receive an elderly person communicates with his family, goes to his home - we study his habits, favorite foods, hobbies, daily routine. It is necessary to create an atmosphere in his new room that is close to the one in which he lived at home - this will significantly increase the possibility of his rapid adaptation,” Alexey Sidnev shares his experience.
Cases of an elderly person moving to a new or another similar institution, unfortunately, are not uncommon, says Lisa Oleskina, head of the Old Age in Joy Foundation. For example, they are inevitable when the “old” institution does not meet fire safety requirements. In her opinion, it is important to first prepare older people as much as possible for what they will see in a new place. The most active wards should be sent there on an excursion along with the staff, so that when they return they will tell in detail about the new place.
How can we help older people adapt quickly in place? Truthfully and clearly explain to them the reason for the move, reassure them that all their belongings will be moved with them, that they will also be accommodated in rooms, as before, that everything will also be close there - both the toilet and the dining room, that they will be able to go outside. street. If you manage to attract them to joint activities - provide them with minimal employment and participation in decision-making (even in choosing the color of the curtains) - consider that you have won.
“It is advisable to immediately help such an old man to adapt - to show him how to get to the dining room, to tell the schedule of his day, week, month with utmost clarity and detail, and if he immediately finds out that his bath day is Tuesday, where he needs to water the flowers, he will feel yourself more confident and calm. This will increase his independence. Then, most likely, he will not lie down all the time, but will start walking and eating on his own again,” says Lisa Oleskina.
Preserving memorabilia and regime
Alexey Sidnev advises taking as many memorabilia as possible to the new place, from photographs to furniture, as well as pets - cats, dogs, birds, if the elderly person has them. (When choosing a boarding house for your old man, be sure to ask if there is such an opportunity.) It is recommended to visit an elderly relative as often as possible, especially at first.
It is important that a person can maintain his usual routine. “If we learned from him or his loved ones that he likes to sleep longer in the morning, let him sleep, and when he wakes up, we will separately feed him what he likes to eat for breakfast,” explains the head of the Senior Group.
Typically, according to Alexey Sidnev, with this approach, primary adaptation takes about two weeks for 80% of older people, the remaining 20% adapt in about a month.
Moving with dementia can be confusing
Psychiatrist, geriatrician and psychotherapist Grigory Gorshunin also insists that moving in old age is a psychological trauma and a reason for mental and physical breakdown.
“If moving is unavoidable, we must keep in mind that if an older person has dementia, the first consequence will be confusion,” says the expert. “In this state, an elderly person can become aggressive, exhibit motor or psychomotor agitation both day and night, do not understand where he is, do not remember who he is, and do not recognize relatives.”
The fact of moving, as Gorshunin explained in professional language, leads to disruption of adaptation in people with dementia. “In this state, at an older age, spatial orientation skills are not formed, a person does not acquire new skills at all, which means he cannot adapt to new conditions, cannot remember what is where,” the expert stated. “Confusion can only be treated with medication.”
According to him, hospitalization may even be necessary - in the hospital the most suitable drugs are selected for the old man. “Properly selected medications relieve confusion in a couple of days,” the geriatrician reassured. “As an ambulance, an acute state of confusion can be relieved with Corvalol or Valocordin, but this is not a panacea and there is no way to bypass treatment.”
Rehabilitation of the soul: to avoid depression
If an elderly person moving to a nursing home does not have dementia, there is still no need to relax, says Grigory Gorshunin; another problem may lurk - depression.
“The person understands that his relatives, as they say, “handed him over” to a government house,” notes the doctor. “A feeling of melancholy falls on him, he suffers like a child. He has to be treated for depression, which arises in response to his location, environment, and strangers. In addition, blood pressure and blood sugar levels change, which creates an additional threat to the health of an elderly person.”
“One of the nannies in a regional nursing home once told me,” the doctor recalls, “that among the non-demented wards there are those who are “accustomed” to hospitals, nursing homes, etc., and there are “home ones” - elderly people who were once surrounded by constant care relatives and caregivers and not adapted to life in a government house. So, the “home ones” are often the most vulnerable: they don’t live long in an institution and can actually die of boredom.”
To prevent this from happening, you need frequent visits from relatives or a 24-hour personal companion nurse who will listen to and talk to the old person.
Lisa Oleskina says that creating the most accessible environment and clearly organized space will help relieve the anxiety that is natural during the first time after moving: good lighting, free passages, renovated stairs.
“It is necessary to remove the stressful perception of the situation as quickly as possible in order to remain active so that a person can plan his future, because anxiety and aggressiveness caused by stress seriously impairs the mental capabilities of an elderly person,” notes the director of the “Old Age in Joy” Foundation.
The most important thing for an old person after moving is not just care, but the rehabilitation of a soul exhausted by life, says Lyudmila Aleksandrovna Zarubina, a specialist in caring for the elderly and disabled with 32 years of experience, once the director of a state hospital for the elderly in the Arkhangelsk region, and today representative of the “Old Age in Joy” Foundation in this institution.
“We involve a person in various activities, we try to convince him that his life is not over,” Lyudmila Aleksandrovna shares her approach. “It is impossible to make the whole world happy, but each of our nurses and aides can choose “their” grandparents with their hearts and give them personal attention and love.”
Health, alas, does not last forever. And often relatives of a bedridden patient have to deal with the problem of transportation - how to deliver the patient for examination, to a boarding house, home after hospitalization, to the train to the railway station or to the airport, because transport services are not included in the list of social services? What to do in such cases and when can you count on the state, and when do you have to take matters into your own hands?
Transportation of patients, or, in official language, medical evacuation, was born simultaneously with ambulance - after a terrible fire at the Vienna Opera, when the victims remained on the street next to the burnt building for more than a day, unable to get to the hospital on their own. The First World War also made its contribution to the formation of the basic principles of transporting bedridden patients, when transporting the wounded ceased to be considered a purely military problem and turned into a medical one. Fortunately, the need for medical evacuation after emergencies is not encountered so often, but the need to transport bedridden patients arises regularly. If the patient’s condition is such that the process is carried out by ambulance, then medical evacuation consists of two stages:
- assessment of the patient’s general condition and provision of necessary medical care at home;
- transportation and continuation of treatment in a hospital of the required profile.
But if a bedridden patient needs to be returned home from the hospital, the relatives have a problem - the ambulance does not deal with such transportation. Indeed, if a person does not need the help of a doctor, it is at least irrational to use a team of medical workers to transport bedridden patients from the hospital for free.
Types of patient transportation
Transportation of non-ambulatory patients, as well as ordinary patients, can be emergency or planned. Emergency is carried out in situations where the patient’s life is in danger or his health condition requires urgent hospitalization. This category also includes cases in which it is necessary to transport a patient from one medical institution to another, since highly specialized care is required. For example, in a general medical hospital there may well be a pregnant woman who has begun to give birth. In this situation, the decision on the need for transportation is made by the head of the hospital, his deputy for medical work or the doctor on duty.
Planned transportation may be necessary:
- during planned hospitalization;
- returning from hospital;
- examinations;
- transportation to a boarding house, hospice, etc.;
- visits to relatives.
Depending on the type of injury (if any) and the general condition of the patient, he can be transported to the car:
- on foot;
- on crutches and with support;
- on hands;
- on a wheelchair;
- on a stretcher.
People with mild somatic pathologies and injuries of the upper extremities are escorted to the car on foot. If the trip is long, it is better to put such a patient in the car, especially if he complains of dizziness.
You can use crutches and support to walk patients with lower leg and foot injuries to their car after immobilization.
Children are carried in their arms. For adults - only in extreme cases, when it is impossible to use a stretcher (for example, it is impossible to turn around on the stairs with them) and it is also impossible to replace them with a blanket.
Patients are transported on stretchers:
- unconscious;
- in a state of shock;
- in case of acute cerebrovascular accident;
- with myocardial infarction;
- women in labor;
- pregnant women with eclampsia or threat of premature birth;
- with moderate to severe surgical or gynecological pathology;
- with spinal injury;
- with traumatic brain injuries.
Before transferring the patient onto a stretcher, it is recommended to lay down a blanket or thin blanket - then it will make transferring easier. The free ends of the blanket are wrapped around the patient. Don't forget about an extra warm blanket and hat if it's cold outside.
Usually the patient is carried head first, but if he has to be carried down stairs, the lower limbs should be in front. Even if the patient himself reacts negatively to this, safety precautions are more important than prejudice.
Rules for transporting a victim
The patient must be prepared for transportation. If it is an emergency, the medical team prepares and stabilizes the patient’s condition, and they also monitor the victim during the trip itself. If the transportation is planned, preparing the patient for transportation falls on the shoulders of relatives.
The patient needs to be reassured and the need for transportation explained. A few days before it, you need to especially carefully monitor his health and take all prescribed medications. The last meal before transportation should be no later than 2 hours before it, and if possible, it is better to transport the patient on an empty stomach. This reduces the likelihood of motion sickness and vomiting.
It is necessary to convince the patient to relieve natural needs shortly before leaving home. A diaper is put on the patient, especially if the trip is long.
Clothing, documents, and personal hygiene items are prepared in advance, but if it is cold outside, the patient is dressed immediately before transportation.
The “approaches” to the patient’s bed and the path to the door must be cleared so that specialists can carry stretchers and other necessary equipment.
During transportation, the patient should not be fed or given water to avoid causing food to enter the respiratory tract or vomit.
Transport services for bedridden patients
So, an ambulance can deliver a patient to a hospital free of charge if his health condition requires urgent qualified medical care. But after the hospitalization period ends, the state, as they say, washes its hands, and transporting a bedridden patient from the hospital home becomes the concern of relatives. Theoretically, the hospital administration can meet halfway and provide transport for transportation, but this cannot be obligated. Private transportation services can come to the rescue.
Private services are always available and, in general, transportation takes place in much more comfortable conditions than hospital transport can provide. The patient is transported under the supervision of qualified personnel. But there is also a downside - due to the fact that transporting bedridden patients requires expensive equipment and trained specialists, it cannot be cheap. The cost of transporting bedridden patients in Moscow starts from 2,500 rubles for transportation within 5 km within the Moscow Ring Road. If the patient weighs more than 150 kg, then an additional orderly will cost at least another 1,000 rubles. And if the patient’s health condition is such that constant medical monitoring is necessary, then the cost of transportation can reach 8,000–10,000 rubles. But many transport companies have social tariffs for preferential categories of citizens - this needs to be clarified in each individual case.
Sanitary transportation of bedridden patients is not an easy task. The state or municipality can help only in emergency cases, when the life and health of a person is in danger and transportation to a hospital is required - this is required by law. In all other cases you have to rely on your own strength. It is strictly not recommended to try to transport a bedridden patient in an unequipped vehicle, especially in an ordinary passenger car; this is dangerous not only for health, but also for life. Private transportation services are equipped with special vehicles, and specially trained employees must transfer the patient in and out of the car and monitor his condition.
With the development of medicine, a large amount of new technology and equipment appears. Unfortunately, not all medical institutions are equipped with it. Sometimes, a particular patient has to travel to another city to undergo the necessary examination or any other procedure as directed by a doctor. Seriously ill people are in a difficult situation, since transportation requires a person who is equipped with medical equipment and has trained medical personnel who will monitor his condition on the way to another city. In the vastness of our vast country, sometimes such patients have to travel long distances.
Thus, transportation of bedridden patients should be comfortable and safe, eliminating the risk of injury. Often, a person with limited movement experiences pain and severe stress at the slightest change in body position. These include serious illnesses, old age, and the postoperative period. A personal car is contraindicated for transporting this category of citizens, and transport specially equipped for the needs of bedridden patients comes to the rescue.
When may it be necessary to transport a patient?
Relatives are faced with the question: how to transport a bedridden patient to another city? In cases of transportation, relatives and the patient themselves have to turn to special private companies, since usually the state program for transporting seriously ill patients involves completing a large number of papers, which requires a huge amount of time, which some patients do not have. Cases when a bedridden patient requires transportation:
- If a person was urgently hospitalized in another city. Usually, upon discharge, relatives want to take the person to their city for further rehabilitation or treatment.
- Bedridden patients with cancer pathologies can be sent for examination to large oncology centers in neighboring cities and even countries.
- Patients with spinal or pelvic injuries can, at the request of relatives, be transported to other cities and hospitals for further treatment.
Thus, transporting bedridden patients between cities is in great demand and important for providing quality medical care.
Public and private organizations transporting bedridden patients
The state ambulance service receives emergency calls and transports patients to inpatient treatment facilities free of charge. At the same time, the organization does not carry out reverse evacuation of a bedridden patient if he is refused hospitalization, and will not take him home after discharge from the department. It is possible to arrange paid transportation, but the bureaucratic procedure takes a lot of time and effort.
The law provides for the creation of non-profit services whose activities include the transportation of bedridden patients free of charge or at minimal prices. As a rule, they operate only in large cities and do not always have everything necessary to provide high-quality transportation to all categories of people with disabilities.
When it comes to evacuation to another city, and even more so to another country, one cannot do without private licensed services for transporting bedridden patients. Special medical transport has all the necessary equipment for the safe delivery of people unable to move independently in accordance with the principle “from bed to bed” along the following routes:
- to medical institutions and back home;
- to rehabilitation, health or diagnostic centers;
- to train stations, airports;
- to other cities, regions, abroad.
Paid services operate around the clock, have a wide range of services, a discount system, trained staff and have various types of transport, which is always ready to help incapacitated citizens, regardless of diagnosis.
The cost of transportation is calculated individually and depends on the chosen type of vehicle, the duration of the trip, the severity of the patient and the professionalism of the service personnel (workers with medical education or a team of orderlies).
Important! In addition to transportation, commercial service personnel may accompany the patient throughout his or her appointment or examination at a medical facility.
Types of transportation
On the territory of the country, there are three types of transportation of bedridden patients to other cities - by rail, by air, and also by moving the patient in a specialized vehicle. The choice is dictated by the patient’s condition, financial capabilities, reason and direction of transportation. In all cases, the person is accompanied by trained medical personnel who have the right to engage in such medical activities. The transportation team includes: a paramedic or doctor, as well as a nurse.
| Rail transportation | Air transportation | Transportation by car |
| As a rule, for this, the company that carries out the transportation buys an entire compartment and equips it with portable medical equipment. This allows you to turn a train compartment into an intensive care ward, in which the patient will be comfortable and under the supervision of staff. | Companies that organize the movement of a patient in this way negotiate with the airline and arrange a seat in the rear of the cabin. Air transportation is suitable for patients who urgently need to be transported over a long distance. | They are carried out in a specialized ambulance equipped with all the necessary equipment, medicines, as well as oxygen supplies for long-distance transportation. |
Important! If the patient is transported abroad, the transportation service staff will provide assistance in preparing travel documents, in cooperation with the embassy, and provide an interpreter.
Transporting a bedridden patient by train
This rarely happens, since it is precisely when it is possible to most fully approximate conditions similar to an intensive care ward due to the spacious compartment and the large amount of necessary equipment that can be placed. In addition, there are special carriages equipped with pneumatic lifts for convenient lifting of a bedridden patient into the carriage.
As a rule, this method of movement is indicated for the most seriously ill patients who require maximum comfort and close supervision by health workers. They are contraindicated against changes in pressure, temperature and other factors that can affect the deterioration of a person’s condition. If during a trip the patient’s well-being becomes a threat to his life, then at the next stop the person is removed and hospitalized in the nearest hospital to stabilize his condition.
This rarely happens, since it is during rail transportation that it is possible to most fully approximate conditions similar to an intensive care ward due to the spacious compartment and the large amount of necessary equipment that can be placed.
Transportation of a bedridden patient by plane
It is important to know that it is necessary to plan the date of transportation to another city in advance, preferably at least 48 hours in advance. Airlines have the right to refuse to provide a seat without giving reasons.
Therefore, the relocation company needs time to find a suitable flight. To fly, you must obtain permission from your attending physician, since factors such as changes in atmospheric pressure, high speed during takeoff, and turbulence can affect your well-being.
They try not to transport seriously ill people on an airplane, because due to the small amount of space inside the cabin, it is not possible to install the amount of equipment that will be necessary. Therefore, the flight is allowed for moderately ill patients and simply bedridden patients who, for one reason or another, need the supervision of medical personnel. Such transportation of bedridden patients from city to city has the most important advantage - speed.
Transporting a bedridden patient by car
The initial configuration of the machines involves monitoring a patient with any diagnosis and severity level. This type of transportation involves the entire team: doctor, paramedic, nurse and driver. Unlike other types of transportation, only one relative can be present if necessary. The patient must be in a stable condition, since transportation involves braking and accelerating the car, turns, and bumps. If necessary, the medical team can stop, seek help from hospitals along the route, and even urgently hospitalize the patient, if necessary.
Transportation of bedridden patients by road is the most popular type of service in the city and beyond. It includes a resuscitation vehicle, an ambulance and a sanitary taxi. The difference between them lies in the degree of staffing with medical equipment and medicines for emergency care, as well as in the qualifications of accompanying specialists. Many services limit their activities to only delivering a bedridden patient to their destination, without providing medical services before, during and after the trip. Others have experienced doctors and paramedics on their staff, which is especially important when moving seriously ill patients who require constant monitoring by a doctor.
All cars must have technical characteristics designed to mentally and physically facilitate the journey of an incapacitated person. This is the presence in a spacious and roomy interior:
- functional soft stretcher with fastenings that fix the body;
- wheelchair and stretcher;
- soft suspension, smoothing out shocks from potholes on the roads;
- climate control system that monitors the maintenance of comfortable conditions;
- disposable bed, pillows, blankets.
Special vehicle equipment
Medical equipment in vehicles used for transporting bedridden patients:
| Kind of transport | Equipment |
| Ambulance, reanimobile, train |
|
| Airplane, helicopter | Additionally:
|
How is the cost of transportation calculated?
Many factors play a role here: the severity of the bedridden patient’s condition, the amount of equipment and medical personnel who will be involved in transportation, and most importantly, the distance. In any case, the further the destination, the higher the price. All companies have their own tariffs, and some even have their own discount system. Therefore, there is no specific price for all clients, since the cost is calculated individually, based on a specific case. Thus, with the level of development of medical care, the question of how to deliver a bedridden patient to another city and even country becomes not as problematic as, for example, several decades ago.
Preparation for the process of transporting bedridden patients
The position when transporting bedridden patients in transport depends on the diagnosis and combination of associated injuries. For successful transportation, it is important to take a number of measures that not only will not harm the health of the non-ambulatory passenger, but will also facilitate the work of the people accompanying him. This includes preliminary hygiene procedures, preparation of documents, tests, medical reports by relatives, psychological support, and monitoring of the patient’s condition by the doctor.
The decision on how to transport a bedridden patient should be made together with the attending physician. After all, a person’s health, and sometimes life, depends on how quickly and professionally the transportation is carried out.
Video
Often the cheapest, but at the same time the slowest and most dangerous way of transporting people with disabilities. Currently, some carriages have specialized compartments equipped for transporting bedridden patients. But never rush to buy tickets; it’s important to weigh everything carefully. In some cases, this method of transporting a bedridden patient may not be the cheapest as it seems at first, since not all settlements in our country have services that provide transportation services for patients, and transporting a patient with limited mobility from the train station to home or hospital may result in a big problem and additional financial costs. Among other things, loading and unloading a bedridden patient from a railway train requires the involvement of more people, otherwise there is a risk of the stretcher tipping over, which will ultimately lead to injury and worsening the patient’s condition.
International and intercity transportation of bedridden patients on regular airlines
The most expensive and complex method of transportation, but at the same time fast and comfortable. Russian airlines transport people with disabilities (wheelchair users and bedridden patients). The leader in the field of transportation of people with disabilities is Aeroflot airline. Other airlines such as S7 Airlines (Siberia), Utair (Ural Airlines - UTair), Nordwind (North Wind) can be considered as alternative options if there are similar routes on each specific route. The deadline for submitting a flight application is from 48 to 72 hours before departure. Each airline determines the cost of transporting a bedridden patient independently; the difference in price on one route can reach several tens of percent; on average, the cost of a medical transportation tariff is equal to the cost of three or six one-way tickets, since the aircraft cabin is transformed to suit the needs of the patient and usually in both directions .
Intercity transportation of a bedridden patient by medical vehicle
The simplest and fastest type of transportation for sedentary patients. It has a number of advantages over rail and air methods of transporting bedridden patients. Transportation of a bedridden patient to another city is carried out without changing the vehicle; vehicles can reach any place where there are roads. This is an inexpensive form of transportation and sometimes cheaper than rail. Despite the fact that sanitary and resuscitation minibuses are much slower than planes and helicopters, due to the fact that much less time is required to supply transport, and there are practically no restrictions on weather conditions, they can often deliver a bedridden patient faster. If we compare the time of transporting a patient by train and ambulance minibus, our many years of experience shows that the travel time differs little; minibuses often deliver faster, since there is no need to waste time changing vehicles.