The Pediatric Palliative Care Centers, like the daytime centers “San Gabriel” and “Dr. Gastón Acosta Rua” in Pérez Zeledón, are intermediate places between the hospital and the home, in which attention is offered to the patients whose management requires treatment in an environment that offers professional resources and that is also friendly and welcoming.

In these centers:

• We are able to educate the family and the healthcare personnel about fundamental aspects of Palliative Care.
• The focus is the quality of live of the patient and his/her family, and attending to all of their necessities.
• We look to maximize self-esteem, minimize dependence, and promote confidence.
• We offer a opportunity to rest for those that watch over these children.
• We guarantee continual care and we promote social interaction through community support networks.
• We avoid the isolation of the patients and their families.
• We channel the community resources, allowing the incorporation of volunteer work and in this way save economic resources.

In the daytime centers the patients are offered the following services:

· Medical Care
· Spiritual Support
· Social Support
· Psychological Support
· Nursing Care
· Entertainment and games
· Special Therapies: Physical Therapy, Occupational Therapy, Art Therapy, Musical Therapy, among others
· Education, training, and support for the family in order to enable them to provide the appropriate care and attention to their child
· Support groups for parents and caregivers
· Support groups for all children present

All of this is designed to provide a space to rest, breathe, relax, and share with family. Moreover, we count on the support of trained volunteers and supervisors for a multidisciplinary team.

The Foundation Centers are:

   · Day Center San Gabriel
   · Day Center Gastón Acosta-Rua

Day Center San Gabriel

In November of 2000, under the management of Dr. Juan Carlos Irola Moya, the Foundation for the Unity of Palliative Care opened the doors of the first day center for Pediatric Palliative Care in Latin America, and one of five around the world, “El Albergue (Shelter/Refuge) San Gabriel.”

The Center is an organized and efficient option for providing care to children and their families in a different environment from either the hospital or their homes. In San Gabriel the patients are evaluated, observed, provided the necessary medicines, and treated with simple procedures. Above all, the center looks to offer them the integral care that fosters learning and entertainment during their stay.

We have in the Center game rooms, a sensory stimulation room, a bath for hydrotherapy, standard patient rooms for children and adolescents, rooms for the parents to rest, a nursing station, a massage room, a kitchen, and a dinning room.

Objectives

General Objectives:

• To offer integral care to the patients and their families in a different environment from either the hospital or the home.
• To provide a positive change of environment
• To allow the patients’ progression to be monitored, so that changes in procedures can be made to provide quality care and attention
• To expand the coverage of care given to the children and their families
• To educate the patient’s family during this process of illness and grief
• To offer efficient and continual attention
• To offer a restful place to those who care for these children
• To provide an opportunity for the community to incorporate itself through volunteer work
• To allow social interaction, and to eliminate isolation of the patient and his/her family   

Day Center Gastón Acosta-Rua

In February of 2007, thanks to and through a benefit called “Sunset in Costa Rica,” hosted by the Foundation Acosta-Rua in Jacksonville, Florida, we took the first step toward decentralization and opened the day center “Dr. Gastón Acosta-Rua” in Pérez Zeledón. We also would like to thank the Board of Directors of the Foundation for their initiative which led to this achievement.

Dr. Gastón Acosta-Rua is our center of operations for bringing care0 to those children of the Southern Zone of our country, through a team of experienced professionals in Palliative Care.

We rented a house that was remodeled and equipped, in order to serve as our care-giving day center, offering services similar to Day Center San Gabriel. Also, we implemented domestic visits for the entire Brunca region and opened a support group for grieving families. 

In this center we offer all of the integral services of Palliative Care, and thanks to the collaboration of organized volunteers and business men and women of the zone, the expansion of these services is becoming possible.

The Foundation covers, also, all of the costs with regard to this center.

Objectives

General Objective:

To offer to the boys, girls, and adolescents with limited living capacities and/or in the terminal phase, that live in the Brunca Region of Costa Rica, integral and continual care, based on the philosophical principles and practices of Palliative Care.

Specific Objectives:

• To offer specialized attention in Palliative Care to the Southern region of the country.
• To make a situational diagnostic of the boys, girls, and adolescents that seek Palliative Care in the Southern Zone.
• To improve accessibility to pediatric Palliative Care.
• To improve the quality of care to those patients who require pediatric palliative services.
• To involve civil organizations, that work in the area of Palliative Care, in the decentralization process
• To improve the analytical capacity of the teams of healthcare providers (EBAIS)
• To train, in basic aspects of Palliative Care, the healthcare providers (EBAIS) and the hospitals of the zone.
• To take advantage of common initiatives in the care of the boys, girls, and adolescents that need Palliative Care services.

Goal:
To reach 100% of the boys, girls, and adolescents in this zone in need of Palliative Care.

Coverage:

• In 2007 we began with a patient base of 12 children, and by 2009 this number increased to 96 patients from:
• Pérez Zeledón : San Isidro del General, General, Daniel Flores, Rivas, San Pedro, Platanares, Pejibaye, Cajón, Barú, Río Nuevo, Páramo.
• Buenos Aires : Buenos Aires, Volcán, Potrero Grande, Boruca, Pilas, Colinas, Chángena, Biolley, Brunca.
• Corredores: Corredores, Ciudad Neily, La Cuesta , Paso Canoas, Laurel.
• Osa: Puerto Cortés, Palmar, Sierpe, Bahía Ballena, Piedras Blancas.
• Golfito : Golfito, Puerto Jiménez, Guaycará, Pavón.
• Coto Brus : San Vito, Sabalito, Agua Buena, Limoncito, Pittier.