The multitude of foreign notions that have came into the Russian language over the last few years are an indication of the changes -- for better or worse -- that have taken place in the life of the country.


One of these new words is hospice. It is by no means as much a household word as voucher, racket or Internet. But it certainly signals a positive change, even though for the time being it is known only to a few and represents a concept not nearly as widespread as in the West.


Last week the first Russian hospice celebrated its fifth anniversary. Hospices, or institutions for people dying of incurable diseases, usually cancer, were started in England in 1967. It took more than 20 years and the efforts of an Englishman, Victor Zorza, for the noble idea to reach Russia. The British journalist's personal experience with his dying 25- year-old daughter became a subject of the book which, perhaps more than anything else, made hospices known. It was this book which inspired Andrei Gnezdilov, a St. Petersburg psychotherapist, to introduce the concept in Russia.


The first Russian hospice opened in Lakhta, outside St. Petersburg. "The hospice in Lakhta," Zorza says, "has everything it should have. This house fully corresponds to the humanitarian purpose we all work for."


Today there are six hospices in St. Petersburg that serve 150 people, although specialists say the demand exceeds 2,000 people. The average period of stay in a hospice is about a month. Although there can be periods when people get better and return home, for most patients the hospice is their final shelter in this world.


Though the hospice movement has finally arrived in Russia, the idea still remains strange to some people, and many are just scared of it.


The driving force behind the new initiative is St. Petersburg's first lady, Lyudmila (Narusova) Sobchak. "The most difficult task," she says, "was to change the psychology of doctors themselves. For many years the very idea of preparing the patient for dying seemed wild." Five years ago then Health Minister Yevgeny Chazov's response to the enthusiasts was: "We have no money for regular patients, and you want to spend it for the doomed."


Narusova's current drive, as the head of the Hospice charity, is to lobby for a change in the law which would make hospices a place for alternative military service, especially for medical students.


The change, which resulted in establishing Russian charities, is perhaps less visible, but in fact is one of the most important psychological transformations. It signals a change away from the Soviet tradition of shunning the doomed, disabled and sick.