Health

The doctor explained everything to her calmly, but even so, a feeling of uncertainty remained in the air… Is this really it? Is there another option? If you’ve ever felt this knot in your stomach, you have every right to seek a second opinion. It’s not a lack of trust. It’s not disrespect. It’s care. It’s wanting to make a clear decision about what matters most: your health. After all, what is a second medical opinion? It’s exactly what it sounds like: listening to another doctor. In essence, it’s asking a second specialist to analyze your case, review the diagnosis or treatment proposed and give you their perspective. It could be through a new analysis of the medical history, requests for additional tests or simply a frank and enlightening conversation. The right to a second medical opinion is one of the patient’s fundamental rights and is provided for in the Charter of the Rights and Duties of the Patient, which means that anyone can and should use it whenever they feel the need. When to ask for a second medical opinion? The truth is that there is no “right” time for everyone. But there are situations where this step can make all the difference: The diagnosis was unclear or seemed uncertain You have a serious, rare or terminal illness You have several treatment options and you don’t know which one to follow Not responding to current treatment Feels they weren’t listened to at the first appointment The treatment proposal seems too invasive, experimental or risky The doctor is not a specialist in your specific condition Or simply… you still have doubts. There are also cases in which the doctor himself may suggest seeking another opinion and this should be seen as a sign of professionalism, not a cause for concern. How do I ask for a second medical opinion? First of all, take a deep breath: you’re not offending anyone by wanting to confirm a diagnosis. It’s your body, your health, your decision. Here are some steps that can help: Speak openly with your doctor. Tell them you’re thinking of getting another opinion so that you feel more secure. Many doctors understand and will even help you Collect all medical documentation. Exams, analyses, clinical reports, prescriptions – everything can be useful. If you don’t have these documents, ask the clinic or hospital for them. This is another patient right, guaranteed by law – you have the right to access your clinical information whenever you need it Choose the second specialist well. You can ask your family doctor for recommendations, your health insurance (many include this cover), go to specialized clinics or even turn to patient associations In the new consultation, be clear. Explain that you’re looking for a second opinion. At first, you can even choose not to share the first assessment straight away, to ensure an unbiased view. Then, with everything on the table, compare the opinions. What to ask at the consultation? Be prepared. Having a list of questions will help you not to forget anything important. And remember: there are no “dumb” questions when it comes to your health. Some questions you can ask: What exactly is my diagnosis? Are there other treatment options? What are the risks and benefits of each? What happens if I don’t do anything now? Would I recommend the same treatment to someone in my family? What if opinions differ? How do you decide? And when doctors don’t say the same? It happens more often than you think and can be disconcerting. The important thing is to stay calm and look at both opinions critically. Here are some tips to help you make your decision: Compare the arguments: which opinion do you think is better founded? Did the doctor explain the reasons clearly? Evaluate the degree of trust: with whom did you feel most comfortable and well-informed? A relationship of trust counts for a lot! Consult additional sources: you can read about the topic on credible health websites, talk to patient associations or even seek a third opinion Talk to both professionals: share your differing opinions and see if one of them re-evaluates their opinion. Sometimes this dialog can lead to a consensus. In the end, the most important thing is to feel safe and well-informed in order to make the best decision for you What if you have to go abroad? If you have a rare or serious illness, or if you need treatments that don’t exist in Portugal, you can ask for a second international medical opinion. Many health insurances already offer this possibility, including support for travel and subsistence costs. So check what your plan covers – it could open important doors. Need support to get to your appointment? Count on Ambula! If you are planning to ask for a second medical opinion and need help getting around comfortably and safely, Ambula is ready to accompany you throughout the process. Because taking care of your health also means making sure you get where you need to go, with peace of mind. Partilhar:

Caring for someone who is bedridden is a profound gesture of love and dedication that requires patience, empathy and attention to detail. Whether for reasons of age, recovery from surgery or an accident, the process of helping the person out of bed can be one of the biggest challenges for the caregiver. On the other hand, it’s also an opportunity to show care, respect and ensure that the person feels calm and comfortable. In this article, we’ll guide you through simple and safe steps, so that the process of lifting a bedridden person is as easy and comfortable as possible for both of you. How to lift a bedridden person: step by step Preparing the environment Before you start, it’s important to prepare the space. Place a wheelchair or armchair next to the bed and make sure it is secure. If it’s a wheelchair, lock the wheels to prevent it from moving during the process. If it’s not a wheelchair, simply lean the armchair or chair against a solid piece of furniture or wall. Position the person on the edge of the bed With the person still lying down, start by gently pulling them to the edge of the bed. Take your time, as the aim is to move the person calmly and avoid any discomfort. Place an arm under their body, at about shoulder height, to help them slide in a controlled and unhurried manner. Support your back and prepare to sit down Support the person’s back with one arm and hold their armpit with the other, helping them to sit up in bed. Remember to bend your knees and keep your back straight to avoid injury. Lift the person gently, pushing with your legs, until they are sitting upright but comfortable. Position your legs Now that the person is sitting up, pull their knees off the bed, letting their legs dangle over the edge. This movement helps stabilize the person and prepares them to be safely transferred to the armchair or wheelchair. Get the person out of bed With the legs already positioned on the edge of the bed, gently move the person off the bed until their feet touch the floor. If necessary, adjust their position to ensure they remain balanced before proceeding. Hug and lift with care Wrap your arms around the person underneath, supporting them firmly. With your other hand, grab the back of their clothes, such as the hem of their pants. If the person is able, ask them to hold onto your neck, which helps to provide stability. Remember: keep your back straight and use your legs to lift the person gently and safely. This movement is essential to avoid overloading the spine. Transfer to the chair When the person is standing or almost standing, turn their body to direct them towards the wheelchair or armchair. Bend down and calmly position them on the seat. Adjust their position, making sure they are comfortable and secure, passing their arms over the back of the chair for greater stability. Additional tips for lifting bedridden people Regular movement. If possible, move the person every two hours to avoid complications such as bedsores (pressure ulcers), and improve blood circulation. Even if the patient is unable to move on their own, it can help to turn the person onto their side or into a sitting position Use support equipment. The use of specialized equipment can greatly ease the physical strain on the caregiver. Beds that can be raised or adjusted make it easier to move around while providing additional comfort for both the caregiver and the patient Keep your posture correct. Posture is key to avoiding injuries. When lifting the bedridden person, bend your knees and use your legs for strength, not your spine. In this way, the movement is made more efficiently and without overloading the body. Communication with the patient. It’s important to communicate with the bedridden person throughout the process. Always ask how they feel and if they are comfortable while moving. It seems like a small gesture, but it helps build confidence and makes the process less stressful Keep the environment safe. Before you start, make sure the environment is safe and organized. Remove any objects that might get in the way, such as loose rugs or out-of-place furniture. An obstacle-free space makes all the difference in preventing falls and ensuring safety for both of you How to clean bedridden people: tips Prepare the environment in advance. Gather all the necessary materials (towels, hygiene products, disposable gloves, clean clothes, sheets, etc.). Make sure the environment is warm and comfortable for the person Maintain privacy and respect. Cover the person with towels or sheets to ensure their privacy. Always ask how they are feeling and make sure the environment is welcoming and comfortable Gentle cleansing. Use gentle movements, starting with the cleanest areas (such as the face), then moving on to the arms, legs, torso and finally the intimate area. Dry the skin well to avoid irritation and pressure sores Beware of risk areas. Pay special attention to areas prone to bedsores, such as the back, hips and heels. When cleaning and bathing, use gentle movements and avoid rubbing these areas. If necessary, use soft towels or cloths and, when drying, do so gently, without pressing on sensitive areas. Use gentle and suitable products. Choose gentle hygiene products without strong fragrances that are easy to rinse off to prevent allergies and irritation. Specific products for sensitive skin are ideal Hand hygiene and materials. Wash your hands thoroughly before and after the process. Use disposable or easy-to-sanitize materials to avoid transmitting germs and keep everyone safe. Do you need to transport a bedridden person? Count on Ambula! If you need to transport a bedridden person to exams, appointments or other trips, Ambula is here to help. With adapted vehicles and trained professionals, Ambula ensures that the person is transported in a dignified manner, without rushing and with the utmost attention to their needs. Count on

Can you imagine the scenario in which the simple task of leaving the house or going to the kitchen becomes a challenge? Reduced mobility can affect any of us, whether due to an accident, a health condition or something as natural as aging. In this article, we’ll explore what it really means to have limited mobility, the obstacles that arise and the solutions to ensure accessibility, without forgetting the fundamental rights that everyone should have in order to live without barriers. What does reduced mobility mean? This condition describes the difficulty or limitation of movement that can arise temporarily or permanently. The affected person may have difficulty walking, standing, sitting or performing daily tasks independently. The causes of this limitation vary and can include anything from chronic illnesses and injuries to ageing or temporary conditions: Older age: aging can lead to a decrease in muscle strength and flexibility, making movements slower and more difficult Chronic diseases: conditions such as arthritis, multiple sclerosis or diabetes can affect the joints, muscles and nerves Injuries and accidents: broken bones, surgery or serious injuries can result in temporary or permanent reduced mobility Pregnancy, toddlers or obesity: many temporary situations can also lead to walking difficulties. It’s important to note that people who suffer from reduced mobility don’t always have obvious problems getting around. A person who has had surgery on their hands, for example, may have difficulty using their hands to perform simple tasks, even though they can walk normally. Rights of people with reduced mobility Access to specialized information. The right to obtain information on rights, benefits and duties from Inclusion Counters, the National Institute for Rehabilitation (INR) or Social Security centers. Priority service. People with a degree of disability equal to or greater than 60% are entitled to priority service in public and private services, except in specific situations Right to complaints and grievances. Possibility of filing complaints in cases of discrimination or lack of accessibility, with the support of responsible officials. The Most Accompanied Person Regime. It allows a person with a disability to be assisted by another person to guarantee the defense of their rights, without conflicts of interest Allocation of support products. Access to products and equipment to compensate for mobility or activity limitations, with simplified financing Support for teaching and training. The right to an inclusive education and adequate support for children and young people with disabilities, guaranteeing active participation in the school community Access to the job market. Specific measures to support disabled people’s access to employment, including quotas and support for integration into the labor market Rights in the workplace. Possibility of requesting adjustments to working hours, adaptations to the workplace and absences for medical treatment without prejudice. Public transport rights. Priority access and reserved seats on public transport, with assistance during boarding, disembarking and travel Independent Living Support Model. Personal assistance for day-to-day activities, such as hygiene, food and travel, with a view to greater autonomy and social inclusion. How to promote accessibility Accessibility is the key to enabling everyone, regardless of their limitations, to live independently and fully. The first step is to ensure that spaces, whether public or private, are adapted to eliminate the physical barriers that hinder mobility. At home Adapting a home for a person with reduced mobility doesn’t have to be a difficult or expensive task. A few simple changes can make all the difference: Large spaces. Make sure furniture doesn’t block the way. Wide doorways and unobstructed corridors are essential, especially for those who use wheelchairs or other mobility devices Adapted bathroom. Installing grab rails in the shower stall or next to the toilet, using non-slip floors and adjusting the height of the sink are all changes that can make the home safer Accessible kitchen. Lower benches or benches without cupboards underneath allow wheelchair users to maneuver easily. On public transport Accessibility in public transport is also essential to ensure that everyone can get out of the house easily and safely. Accessibility laws in Portugal, such as Decree-Law 163/2006, require that buses, trains and subways be prepared to receive people with reduced mobility. This includes: Adapted vehicles. Buses with ramps and seats reserved for wheelchairs Accessible signage. Sound and visual signals at stops and inside transport for people with sensory disabilities Stations and platforms. Ramps, elevators and escalators must be present to facilitate access for anyone. In public and private buildings Law 46/2006 guarantees that public and private buildings, whether new or refurbished, are adapted for accessibility. This includes: Access ramps: to eliminate stairs and allow people with reduced mobility to move around more easily Elevators and wide doors: ensuring that anyone can move freely through the space Adapted toilets: so that everyone can use the space with the same dignity and autonomy. Improving quality of life: some tips Although adapting environments is fundamental to improving the quality of life of people with reduced mobility, taking care of physical and emotional health and well-being as a whole is essential to increasing autonomy and comfort. Here are some practical tips to make everyday life easier and more enjoyable: Practicing adapted physical exercises such as aqua aerobics, pilates or yoga helps to improve muscle strength, flexibility and mobility. Maintaining a healthy and balanced diet is important for general health and prevents diseases that can aggravate mobility limitations Seeking emotional support and taking part in support groups or therapies is an excellent way to deal with the emotional issues related to reduced mobility Investing in assistive technologies can increase independence and help you carry out daily tasks more efficiently Maintaining a regular rest and sleep routine is also very important, as adequate rest contributes to physical and mental recovery Having a social support network, made up of family and friends, gives you the support you need to face your daily challenges more calmly and safely. Partilhar:

Facing a cancer diagnosis brings many challenges, and the difficulties go far beyond the fight against the disease. On a day-to-day basis, there’s also managing travel to treatments, appointments and exams, which can be a huge burden. But we have good news for you. There are rights that make these journeys easier and offer the necessary support so that the focus can be on treatment and well-being. Is transportation to treatment a guaranteed right? Cancer patients are entitled to transportation, particularly in the case of regular treatments or consultations that require frequent travel. To guarantee this support, there are certain conditions and processes that must be followed. Access to non-emergency transport In cases of non-urgent transportation, i.e. when it is not an emergency, cancer patients can access free transportation or transportation with costs reimbursed by the National Health System (SNS), as long as they meet certain requirements. The main criterion is the need for transportation under special conditions, such as ambulance transportation, when the person has difficulty moving (for example, when transportation in a wheelchair or in a bedridden situation is necessary). Conditions for obtaining transportation In order for a cancer patient to enjoy this right, a prescribing doctor must issue a credential proving the need for transportation. This credential will be delivered to the administrative services of the hospital or health center, which will process the request. Transportation can be prescribed for treatments related to the cancer disease or, in some situations, for palliative care. Travel expenses If the patient needs transportation, and is in a difficult economic situation, the SNS can cover the full cost of transportation. If the person has a degree of disability of 60% or more, transportation is fully reimbursed, which means that even in situations of great financial strain, health should never be an obstacle to accessing treatment. This includes transportation in ambulances or vehicles suited to the patient’s needs. The importance of the medical certificate of incapacity In order for the patient to have access to these facilities, they must have a Medical Certificate of Multipurpose Disability . This official document certifies that the person has a degree of disability equal to or greater than 60%, which allows the patient to access exemptions and co-payments in various areas, including transportation to health care. You can obtain this certificate after a clinical assessment and, if approved, it offers a series of benefits, such as exemption from user fees at hospitals and health centers, as well as access to other important rights, such as reimbursement for medicines. How transportation works in the SNS When transported by the NHS, cancer patients can be transported by ambulance or simple patient transport vehicles. The choice of the appropriate means depends on the patient’s clinical situation. For example, if the person is unable to walk or is bedridden, they will be transported by ambulance. It is important to note that this transportation is not limited to a single trip, but can be requested for several appointments or treatments, as necessary. The SNS guarantees that transportation will be provided whenever it is medically necessary, which ensures greater peace of mind for patients and their families. For more information, see the Frequently Asked Questions available on the Health Regulatory Authority website. How do I request transportation? To request this type of transportation, the patient must obtain a medical prescription proving the need for the service – the Multipurpose Certificate mentioned above – with a detailed clinical justification. With the prescription in hand, the user can: Request transportation from the health services in your area Contact entities authorized to provide this service directly (fire departments, Red Cross, associations or specialized companies such as Ambula). In some health units, such as IPO Lisboa, the management and scheduling of transport for non-urgent patients is done centrally by the Transport Center. To take advantage of this service: Patients must make an appointment in advance, directly through the MyIPO Lisboa platform You can also apply by e-mail(centraltransportes@ipolisboa.min-saude.pt), telephone (217 229 800 / 217 200 400) or in person at the hospital. Specialized transport and specific clinical situations In the case of patients who need special care during transportation, such as those who require isolation or medical care during the journey (for example, in cases of chemotherapy or radiotherapy treatment), the SNS ensures the availability of ambulances equipped with the necessary resources. These ambulances are adapted to ensure that transportation is safe and comfortable, and that adequate care is provided for each patient’s specific conditions. Ambula as the ideal solution for transporting non-emergency patients For those who need non-urgent transport, Ambula offers a specialized transport service that provides comfort and safety on every journey. If you are looking for a practical solution adapted to your transportation needs, Ambula is available to guarantee your mobility, always with the care and attention that an oncology patient deserves. The role of support institutions Organizations like the Portuguese League Against Cancer play a very important role in this process by providing additional support to cancer patients, either by offering transport or with other types of financial and social assistance. The LPCC, for example, can help cover the costs of medication, technical aids and transportation, providing crucial support in difficult times. The League also collaborates with hospitals and other health institutions, helping to fill gaps in the system and ensuring that patients have access to the necessary treatment and follow-up. Partilhar:

Getting older is a natural process and, although each stage of life brings new challenges, old age doesn’t have to be synonymous with loneliness or difficulties. Fortunately, in Portugal, there is a vast network of support designed to ensure that the elderly can live with dignity, security and well-being. Whether through financial support, health services or personalized social responses, the aim is to enable all older people to age with quality and maintain independence and an active lifestyle. Find out more about the main support available. Financial support In old age, financial security is an important pillar for a peaceful life. From monthly pensions to extraordinary supplements, Portugal has various forms of support that ensure the elderly can live with dignity, even when their income drops after retirement. Old-age pension: at the age of 66 years and seven months, citizens are entitled to a monthly pension – known as “reforma” – to replace the income lost when they stop working, provided they have at least 15 years of Social Security contributions. Social old-age pension: for those who do not have sufficient deductions, there is financial aid for elderly people on very low incomes Solidarity Supplement for the Elderly (CSI): a monthly support for elderly people on low incomes, which also offers additional health benefits such as discounts on medicines, glasses, dental prostheses and medical consultations. Extraordinary pension supplement: additional financial support granted to pensioners on lower incomes to ease financial burdens and ensure greater economic stability. Dependent spouse supplement: low-income couples, where one of the spouses receives up to 44.61 euros Social support for elderly emigrants in need: elderly Portuguese, aged 65 or over, who live abroad and are in a situation of vulnerability or need, may be entitled to social support, which should be requested at consular posts Extraordinary social support for energy consumers: CSI beneficiaries can ask for a reduction in the price of electricity and natural gas, accumulating this discount with the social tariff. Health support While financial security is important, quality of life in old age also involves health. Those who receive CSI, for example, have access to a range of benefits that help to reduce health costs and thus provide relief from daily expenses.Among the support available are: Expenses with medicines: receives 50% of the part not reimbursed by the state, relieving the cost of prescriptions Purchase of glasses and lenses: 75% co-payment of up to 100 euros every two years, to ensure clearer and more comfortable vision Purchase or repair of removable dentures: the CSI covers 75% of the cost up to 250 euros every three years, helping to take care of oral health Dental voucher: additional support for dental treatment. Reimbursements are made upon presentation of the medical prescription and the respective receipt at the Health Center, and are paid together with the Solidarity Supplement for the Elderly. To claim these benefits, you will need to present a Social Security statement proving your entitlement to CSI when you first apply. Social support Social Security and Private Social Solidarity Institutions (IPSS) have developed a vast network of social support for the elderly. Social centers: promote social and cultural activities that encourage the active participation of the elderly and prevent loneliness, fostering new interpersonal relationships. Day centers: for elderly people aged 65 and over, day centers offer continuous support that stimulates autonomy, self-esteem and postpones the need for permanent institutionalization. Night center: designed for elderly people who live alone and feel insecure at night, they offer overnight care, providing greater security and peace of mind. Vacation and leisure centers: the chance to relax and discover new places is essential for the well-being of the elderly. Vacation centers offer moments of relaxation and group living, ideal for those who have autonomy. Home support service: for elderly people with greater dependency, this service provides support with day-to-day tasks such as hygiene, feeding and domestic care. Residential facilities: offer collective accommodation for the elderly, both temporarily and permanently, with environments adapted to their needs. Family foster care: families prepared to take in elderly people can provide temporary or permanent support. Financial support in Portugal is undoubtedly an important help and, compared to many countries, offers a significant support network. But unfortunately, for many elderly people, they are still not enough to guarantee a life without worries. According to the National Statistics Institute (INE), more than 400,000 elderly people live on a maximum of 551 euros a month, far below the amount needed to ensure a dignified life. Latest measures to support the elderly In recent years, the government has been implementing new measures to support the elderly population. The highlight is the Statute of the Elderly which promotes the active participation of the elderly in society, thus encouraging more dignified and inclusive ageing. A significant increase in the financial contribution for social services for the elderly, such as nursing homes and day care centers, was also approved, with a 3.5% increase in funding. This measure helps to alleviate the effects of inflation and guarantee the continued operation of these essential services. How can I access this support? In order to access any of these benefits, it is important for the elderly or family members to check with Social Security, local authorities or IPSSs in their area. Most of these benefits can be applied for at Social Security offices or Citizen’s Shops, where you can get advice and fill in the necessary forms. Partilhar:

When faced with a health problem, the question can arise: should I call Saúde 24 or 112? Knowing when to call each service makes all the difference in ensuring that you get the right help at the right time. What is 112? 112 is the European emergency number and should only be used in serious situations that pose an imminent danger to life or require urgent medical assistance. In Portugal, it is INEM (National Institute of Medical Emergency) that receives and manages these calls, sending the appropriate means of assistance, such as ambulances or medical vehicles. When to call 112? You should call 112 whenever you are faced with a situation that puts someone’s life at risk or requires immediate help. Some examples: Altered state of consciousness or fainting Suspected stroke (difficulty speaking, asymmetrical smile, weakness on one side of the body) Severe breathing difficulties Choking unsuccessful after attempt to clear the obstruction Serious accidents with injuries Intense chest pain, a sign of possible heart attack Uncontrollable or very heavy bleeding Serious burns or burns to sensitive areas of the body. What should I do when calling 112? Stay calm and describe the situation clearly Indicate your exact location Answer all the operator’s questions Only hang up the call when you are told to. What is Saúde 24? The Saúde 24 hotline (808 24 24 24) is a telephone triage and medical advice service, available 24 hours a day for non-emergency situations. Through this service, health professionals assess the symptoms and advise on the steps to follow, and can recommend self-care, referral to a health center or, if necessary, to an emergency service. When to call Saúde 24? If the situation is not serious but you need medical advice, Saúde 24 can help. Examples of situations in which you should call: Persistent fever, without other serious symptoms Persistent cough or flu-like symptoms Nausea, vomiting or diarrhea without signs of severe dehydration Mild to moderate pain (throat, ears, stomach, head) Minor allergic reactions or skin changes Small cuts or wounds without heavy bleeding Mild changes in blood pressure, with no other associated symptoms Persistent crying for no apparent reason. Advantages of calling Saúde 24 Immediate medical advice without the need to travel Appropriate referral to the right level of care (self-care, health center or emergency room) Availability 24 hours a day, every day of the year Avoiding unnecessary emergency room visits, reducing hospital waiting times Support in various areas, including questions about symptoms, medication and vaccinations. Advantages of calling Saúde 24 Have your SNS user number, name and date of birth with you Describe the symptoms and indicate how long ago they appeared Follow the recommendations of your health professionals. If the Saúde 24 team realizes that the situation may be more serious than it seems, the call can be forwarded directly to INEM, guaranteeing the necessary help. 112 or Saúde 24? Which number should I choose? Situation Call Saúde 24 Call 112 Fever, cough or moderate pain Yes No Severe chest pain No Yes Small wounds without heavy bleeding Yes No Abundant and uncontrollable bleeding No Yes Suspected stroke No Yes Questions about medication or minor symptoms Yes No Serious accident with injuries No Yes What happens if I call the wrong number? If you call 112 with a non-urgent health problem, the call will not be prioritized and could end up overloading the emergency line, delaying the response to really serious cases. Operators may redirect you to Saúde 24, but this represents unnecessary time that can be avoided by choosing the right contact from the start. On the other hand, if you call Saúde 24 in a critical situation, the health professionals can identify the seriousness of the case and transfer the call to INEM. But note that this step delays the dispatch of help by a few minutes, which can be crucial in emergencies such as stroke or cardiac arrest. Other important contacts Poisons Information Center (CIAV) – 800 250 250: support in case of poisoning, available 24 hours a day. SNS 24 Psychological Support Line – 808 24 24 24 (Option 4): psychological support for emotional crises and mental health problems with specialized and confidential service National Social Emergency Line (LNES) – 144: support for victims of domestic violence, homelessness and other social emergencies. Service available 24 hours a day SOS Child Helpline – 116 111: support for children at risk or in emergency situations. Free and confidential service SOS Voz Amiga Line – 213 544 545 | 912 802 669 | 963 524 660: emotional support for people experiencing loneliness, anxiety or depression with anonymous and confidential service Elderly Citizen Helpline – 800 203 531: support for elderly people in situations of vulnerability or mistreatment with free and confidential assistance. Count on Ambula! If you need to be transported to a health facility and the situation doesn’t require calling 112, we offer a non-emergency ambulance service and guarantee a safe, comfortable journey with expert assistance. Count on Ambula for efficient transportation whenever you need it! Partilhar:

Shingles, also known as herpes zoster, is a viral infection that can appear at any time of life, but is more common in adults over the age of 50. It is a reactivation of the chickenpox virus, which remains dormant in the body after the person has had the disease. When the immune system weakens, the virus can reawaken, causing very uncomfortable symptoms. If you’ve heard of this condition and want to know how to identify it, what the risks are and how to treat it, read on. What is the zone? The area is caused by the same virus that causes chickenpox, varicella-zoster. After a person has chickenpox, the virus doesn’t disappear completely – it stays “hidden” in the nerve cells. It may never cause problems again but, in some people, it reactivates years later, manifesting itself in the form of a zit.Unlike chickenpox, which affects several parts of the body, a zit usually appears in a specific area of the skin (usually following the path of a nerve). Symptoms of the area In the first few days, symptoms can be confused with other conditions: Localized pain (usually on one side of the body) Burning or tingling sensation Fever and chills Headache Tiredness and general malaise. After this initial phase, the characteristic rash appears. It starts with red spots that quickly develop into small blisters filled with fluid. These blisters can be very painful and, in some cases, even the simple touch of clothing on the skin can be uncomfortable. Over time, the blisters dry out and form scabs, which eventually fall off after two to four weeks. Here’s how lesions can appear on the skin, from the first signs to the formation of scabs. Warning: Images may be sensitive for some people. Where do the lesions appear? The area can appear anywhere on the body, but is most common on the torso, face and around the eyes. It usually only affects one side of the body, following the path of a nerve. If the infection reaches the eye area (ophthalmic area), it can compromise vision and, in severe cases, lead to blindness. Is the area contagious? Yes and no. Anyone who has had chickenpox cannot “catch” it from someone else. However, someone who has never had chickenpox can contract the disease if they come into contact with the blisters of an infected person. For this reason, those who have it should avoid direct contact with pregnant women, babies and people with weakened immune systems. What can cause the virus to reactivate? The virus can remain inactive in the body for decades, but certain conditions can increase the risk of reactivation: Older age: the area is more common after the age of 50 Weakened immune system: people with diseases such as AIDS, cancer or undergoing treatments such as chemotherapy are more vulnerable Stress and fatigue: chronic stress can affect the immune system and facilitate the reactivation of the virus Surgery or trauma: some medical procedures can contribute to the reappearance of the infection. Treatment of the area There is no definitive cure, but there are treatments that help relieve symptoms and speed up recovery. Treatment should begin as soon as possible, ideally within the first three days of the lesions appearing. It is essential to consult a doctor as soon as the first signs of the disease appear, as treatment is most effective when started within the first 72 hours of the lesions appearing. How is the diagnosis made? Diagnosis of the area is mainly based on symptoms and observation of skin lesions. In doubtful cases, laboratory tests can be carried out to detect the presence of the active virus in the body. Medicines used Antivirals (acyclovir, valacyclovir): help reduce the duration of the disease and the intensity of symptoms Analgesics and anti-inflammatories: relieve pain and discomfort Anesthetic creams or gels (lidocaine): can be applied to the skin to reduce pain Cortisone (in some cases): used to reduce inflammation and the risk of post-herpetic neuralgia Medications for post-herpetic neuralgia (amitriptyline, gabapentin): used when the pain persists after the lesions have healed In addition to medical treatment, some measures can help relieve symptoms: Wear loose clothing to avoid friction with the skin Avoid touching or scratching blisters to prevent infection Keep skin clean and dry. How long does it take for the disease to pass? In most cases, this viral condition lasts between two and four weeks. The cycle begins with pain and tingling on the skin, followed by the appearance of rashes and fluid-filled vesicles. These eventually dry out and form scabs, which gradually fall off. Some people may continue to experience persistent pain in the affected area, a condition called post-herpetic neuralgia, which can last for months or even years. Recovery time can vary depending on age, the state of the immune system and how quickly treatment was started. How to prevent the area? The best way to prevent shingles is through vaccination. The shingles vaccine doesn’t guarantee total protection, but it significantly reduces the risk of developing the disease and the severity of symptoms. It is recommended for people over 50 and for risk groups. Currently, the vaccine is not reimbursed by the SNS, which means that the cost is borne by the user. The price is around 180 euros per dose, and two doses are needed to guarantee effective protection. For many, this can be an obstacle to accessing prevention. Faced with this reality, doctors and patient associations have called for the vaccine to be included in the National Vaccination Program, especially for those at higher risk of complications. If you have any doubts about the vaccine, talk to your family doctor and see if it makes sense for you. Strategies to prevent reactivation of the virus A balanced diet and physical exercise to strengthen the immune system. Stress management through meditation, yoga or relaxing activities. Adequate rest to avoid extreme fatigue and maintain the body’s defenses. Control of chronic diseases such as diabetes or

Choosing between hemodialysis and peritoneal dialysis may seem like a complicated decision, but it is, above all, a choice about what best suits the day-to-day life and needs of each patient. Each method has its own particularities, advantages and challenges, and understanding these differences is the first step towards making an informed and calm decision. So, come with us to explore, in a simple and practical way, what distinguishes these two options and how they can influence quality of life in the treatment of kidney failure. What is dialysis? It is a treatment that replaces some of the kidneys’ vital functions. Essentially, when the kidneys are no longer able to eliminate toxins and excess fluids from the body, this procedure becomes essential to maintain the chemical balance in the body. Dialysis acts as life support, removing metabolic waste, regulating potassium and bicarbonate, and removing accumulated fluids. Although it does not fully replace all kidney functions, dialysis is essential for prolonging life and guaranteeing an acceptable quality of life for patients with chronic kidney failure. What is peritoneal dialysis? Peritoneal dialysis is an alternative that uses the peritoneal membrane as a natural filter. In this method, a dialysis fluid is introduced into the abdominal cavity via a catheter, allowing toxins and excess fluids to be removed by diffusion and osmosis. There are two main types of peritoneal dialysis: Ambulatory Continuous Peritoneal Dialysis (CAPD): the patient manually performs several fluid changes throughout the day Automated Peritoneal Dialysis (APD): a machine carries out the changes during the night, giving you more freedom during the day. This method is mostly done at home and offers greater autonomy and flexibility. What is hemodialysis? In hemodialysis, blood is removed from the body and filtered through a machine, where a dialyzer (or “artificial kidney”) removes toxins, excess potassium and accumulated fluids. This process is usually carried out in dialysis centers or units, three times a week, for around four hours per session. Alternatively, it is possible to carry out hemodialysis at home, although this is less common. The advantages of hemodialysis include the ability to quickly correct metabolic and water imbalances. However, it requires vascular access, such as a fistula or catheter, and can cause discomfort such as cramps or hypotension. What are the causes of kidney failure? Diabetes is the most common cause of high blood sugar levels Hypertension, which damages the blood vessels in the kidneys over time Hereditary kidney diseases such as polycystic kidney disease Glomerulonephritis (inflammation of the kidney filters) Frequent urinary infections that can lead to serious kidney complications Excessive use of medication, especially painkillers and anti-inflammatories Urinary obstructions caused by kidney stones, tumors or prostate enlargement. Hemodialysis and peritoneal dialysis: main differences Both methods have advantages and disadvantages, and the choice depends on factors such as the patient’s state of health, lifestyle and personal preference. Here are the main differences between them: Hemodialysis Peritoneal dialysis Place of treatment Dialysis centers or at home At home (mainly) Frequency 3 times a week Daily Technique Machine-filtered blood Use of the peritoneal membrane Access Fistula or vascular catheter Catheter in the abdominal cavity Autonomy Minor Larger When is hemodialysis the best option? For patients with chronic renal failure in advanced stages When peritoneal dialysis is not possible due to medical or lifestyle conditions Suitable for those who prefer a controlled environment, under the supervision of health professionals Ideal for patients who need to quickly remove toxins from the body. And for whom is peritoneal dialysis the best option? Patients who wish to undergo treatment at home and have greater flexibility in their daily lives Those with vascular access difficulties, making hemodialysis impossible People with a stable routine who feel comfortable managing the process autonomously Those who prefer to avoid frequent trips to the hospital. Where to have hemodialysis and peritoneal dialysis treatments? Hemodialysis and peritoneal dialysis treatments can be carried out in various locations: Dialysis centers and units: these units are spread throughout the country and offer specialized support. See the list of units on the website of the Portuguese Renal Insufficiency Association (APIR). At home: both hemodialysis and peritoneal dialysis can be carried out at home in order to provide greater comfort and flexibility for the patient. Do you need transportation for dialysis? Ambula guarantees safe, comfortable transportation adapted to your needs for your hemodialysis or peritoneal dialysis sessions. Our team of professionals is ready to ensure that you reach your destination smoothly and on time. If you need specialized transport for your treatments, you can count on Ambula! Partilhar:

Having a family doctor is more than just an administrative formality. It’s ensuring that someone knows your health history, monitors your well-being and is there for you when you need them most. Despite its importance, many people still have doubts about how to access this service. If you’re among those looking for answers, read on to find out if you have the right to a family doctor, how you can request one and what has changed recently in terms of access to this service in the National Health Service (SNS). What is a family doctor? Also called general practitioners, they treat immediate health issues and monitor the physical, emotional and social development of their patients throughout their lives. The main responsibilities of a family doctor include: Primary health care. Diagnoses and treats common health problems, offering advice on prevention and well-being Continuous monitoring. Establishes a lasting relationship with users, often spanning several generations of the same family Prevention and health education. It works to promote healthy lifestyles and prevent diseases, helping to reduce future risks Care coordination. Ensures integrated health management, liaising with other specialists and services whenever necessary Holistic care. It values the user as a whole, taking into account physical, psychological and social aspects. First point of contact. It acts as the gateway to the health system, responding to initial concerns and guiding the next steps. When should I see a family doctor? General health issues: pains, fevers, infections, allergies or other non-urgent health problems Chronic diseases: monitoring and adjusting treatments for conditions such as diabetes, hypertension or asthma Routine examinations: regular check-ups, including blood tests, cholesterol screening and blood pressure measurements Vaccination: administration of vaccines provided for in the National Vaccination Program Mental health: initial support in cases of depression, anxiety or other psychological problems, with referral to specialists if necessary Prevention and health advice: guidance on healthy lifestyles, nutrition, smoking cessation and disease prevention Reproductive health: family planning, contraception, pregnancy issues and screening tests Prescriptions and renewals: obtaining medicines for continuous use or prescribing new treatments Referral to specialists: evaluation and referral for specialized consultations or specific treatments Absences and certificates: issuing justifications for work, school or sporting activities. Who has the right to a family doctor? In Portugal, anyone registered with the National Health Service (SNS) has the right to a family doctor, including: Portuguese citizens Legal foreign residents Beneficiaries of international agreements Refugees and asylum seekers. However, the assignment of this professional depends on availability at the health unit in the area of residence. Priority is given to: Pregnant women Children up to 12 years old Chronic patients. How to ask for a family doctor To request a family doctor, follow these steps: Registration with the SNS. Start by registering with the National Health System (SNS). Go to the Health Center closest to your area of residence with the following documents: Citizen’s Card or other valid identification document and proof of residence (such as a utility bill or tenancy agreement).During this process, you will be registered in the National User Register (RNU) and receive your National User Number (NNU). At the request of the family doctor. Once you are registered with the SNS and have your User Number, ask at the Health Center to be assigned a family doctor. Availability depends on the number of doctors in your area, but once you’ve been assigned one, you’ll be able to start booking primary healthcare appointments. In some regions, it is possible to start the registration process online through platforms such as the SNS Portal or SNS 24, but the most common method is still in person at the Health Center. How do I know if I have a family doctor? To check if you have been assigned a family doctor, you can: Consult the Health Center. Go to your health center and ask for this information Check in the MySNS application. In your personal area, you can check if you have a family doctor associated with you Contact by phone or e-mail. Your Health Center can provide this information through the contacts available. If you don’t yet have a family doctor, you will be included on a waiting list and may, in urgent situations, be seen by other health professionals at the center. What if I don’t have a family doctor? If you don’t have a doctor assigned to you, you can go to: Resource consultations: available at specific times in the Health CenterSNS 24: for appointments and information on health care Or emergency services. New rules for 2025 Since January 2025, the government has introduced new priorities for the allocation of family doctors: Extended child priority: children up to the age of 12 (previously up to the age of two) are given priority Attention to specific groups: pregnant women and the chronically ill maintain priority Loss of entitlement: emigrants and foreign residents who have not had a consultation in the last five years may lose their family doctor. These measures come as part of the Health Emergency and Transformation Plan, with the aim of improving the management of available resources. Do you need transportation to your appointments? For users who need to travel frequently to appointments or treatments and face mobility difficulties, Ambula offers a non-emergency patient transportation service that ensures they can travel comfortably and efficiently to the healthcare they need. The family doctor’s most frequently asked questions How do I find a family doctor? You must register at your local health center. Allocation depends on the availability of doctors in the area. How much do you lose the right to a family doctor? Entitlement is lost if you change your area of residence without updating the register or if you cease to be eligible according to SNS criteria. How to contact a family doctor Use the Health Center’s channels, such as the reception desk, e-mail or the MySNS application. How can I get an appointment without a family doctor? You can go to the complementary care of the Health Center or

Every day, thousands of people dedicate their time and energy to caring for someone with mobility difficulties, chronic illnesses or physical limitations. However, this care goes far beyond a simple task: it is an emotional and physical commitment that requires courage, patience and dedication. Find out more about this fundamental but often invisible role. Find out how it works, how to request it and what other useful features you can find on the SNS 24 Portal and the SNS 24 App. What is the Informal Caregiver Status? Created precisely to recognize the importance of this role, the Statute for Informal Car ers guarantees the rights and support of carers who help people with dependencies on a daily basis, whether due to age, illness or disability. It offers a series of benefits and also defines duties that make the task fairer and more balanced. What are the rights of the informal caregiver? Informal caregivers duly recognized by Social Security have access to a series of rights aimed at ensuring their well-being and ability to care: Support and training. They can receive specific training and support from health professionals, from the evolution of the cared-for person’s illness to the best practices for providing care Psychological support. This right extends even after the death of the person being cared for, guaranteeing emotional support at a delicate time Rest periods. To prevent burnout, caregivers are entitled to annual breaks, which can be adjusted to their needs Student worker scheme. If they are attending an educational institution, they have access to the benefits of this scheme Support allowance. A financial benefit for primary caregivers, subject to certain income conditions (explained below) Specific intervention plan (SIP) . This document is drawn up in conjunction with health and social security professionals and details the needs of the caregiver and the dependent person. Teleworking and flexible working hours. Non-primary caregivers can request teleworking, as long as it is compatible with their duties. What are the duties of the informal caregiver? Being an informal caregiver is not just a right; it also entails responsibilities: Ensuring the well-being of the person being cared for. This includes daily support, administering medication, promoting autonomy and maintaining a safe and comfortable environment Provide permanent care. The caregiver must ensure that the person being cared for receives the necessary care in terms of health, food and hygiene Collaboration with professionals. The caregiver must inform the services of any relevant changes and take part in the planned training sessions Compliance with legal obligations. It includes informing Social Security of changes such as the end of cohabitation, death of the person being cared for or withdrawal from the status Support socialization. The caregiver is also responsible for encouraging the person being cared for to remain socially active, where possible Continuous monitoring. The person being cared for must be constantly monitored, regardless of whether they are at home or in some kind of institution. Who can be considered an informal caregiver? An informal caregiver can be: Family member: a spouse, sibling, child or other family member up to the 4th degree of the straight or collateral line Non-family caregivers: the novelty introduced by the law in 2024 is the possibility of non-family caregivers, such as friends or neighbors, obtaining this status, as long as they have the same tax address as the person being cared for. What are the requirements and conditions for becoming an informal caregiver? To be recognized as an informal caregiver, the applicant must: Be of legal age Legally resident in Portugal Be in good health to be able to care for the dependent person Be a relative of the person being cared for or, in the case of non-family carers, have the same tax address as the person being cared for. In addition, to be a primary caregiver, the person must live with the person being cared for and provide care on a permanent basis. Formal and informal care: what’s the difference? The main difference between a formal and informal caregiver lies in the relationship with the person being cared for. The formal caregiver is a professional who works in health institutions or care services and is paid for it. The informal caregiver, on the other hand, is someone from the family or a friend who takes care of someone without pay, on a voluntary basis. And main and non-main informal caregiver? The distinction between main and non-main informal caregivers has to do with the intensity and permanence of the care provided. The main caregiver lives with the dependent person and is dedicated to caring for them on an ongoing basis, without receiving remuneration. The non-main caregiver, on the other hand, provides care on a more sporadic basis and may have another paid occupation. How to apply for Informal Carer Status? To apply for the status, the caregiver must go to Social Security, either online or in person. The process is simple, but requires the person being cared for to give their consent and provide a medical statement proving their dependency. How do I apply for the main informal carer’s allowance? The subsidy is applied for when the caregiver formalizes the request for recognition of the status. The informal caregiver support allowance is awarded to those who meet the requirements, such as being the main caregiver and not receiving any remuneration for the care provided. How much is the informal carer’s allowance and how is it calculated? The monthly allowance for main informal caregivers depends on the household’s means test. In 2025, the conditions are considered to be met if the household’s reference income is less than 1.3 times the IAS, or 679.25 euros. The amount of the allowance is calculated by the difference between the household’s income and the value of the IAS, which this year is 522.5 euros. For example, if the monthly income is 300 euros, the allowance will be 222.5 euros (522.5€ – 300€). The allowance can be increased if the main informal carer is registered with the