Dying at the end of mainland Asia: palliative care in Singapore

Continuing our series on South East Asia, Dr Natalie Evans visits Singapore to find out more about palliative care in this island country. Dr Evans is a Visiting Post-Doctoral Research Fellow at Monash-Seaco Malaysia from the University of Amsterdam and is currently working on a project on health and social care needs of elderly people living alone in Segamat, Malaysia.

 

“There is an end to everything and I want mine to come as quickly and painlessly as possible, not with me incapacitated, half in coma in bed and with a tube going into my nostrils and down to my stomach.”

Lee Kuan Yew, Former Singaporean Prime Minister 1923-2015

Dr Natalie Evans

Dr Natalie Evans

Former Singaporean Prime Minister Lee Kuan Yew made his personal vision of a good death perfectly clear. Following the death of the island state’s former leader in March 2015, now is a pertinent time to reflect on the services that aim to help every Singaporean die according to his or her wishes. Hospice and palliative care services, which trace their origins to mid-80s grassroots initiatives to provide home care for cancer patients, have developed rapidly in Singapore with strong state support. The first hospices were established in the late-80s and the first hospital palliative care services in the mid-90s. Palliative care providers now offer services in hospital, hospice, home, and daycare settings. Palliative care is also a recognized medical subspecialty and an obligatory part of medical undergraduate training. Indeed, the country has a National Strategy for Palliative Care, reflecting a level of acceptance and integration that many countries with longer histories of palliative care services have yet to achieve.

I recently visited Singapore’s Dover Park. This stand-alone facility in central Singapore is similar to hospices found all over the world, with a multidisciplinary team holistically caring for patients’ physical, psycho-social and spiritual needs. Facilities include shared and private patient rooms as well as a garden and multi-faith prayer room. The strong volunteer programme is responsible for activities such as patient outings to pet-assisted therapy. Volunteers also man a special vigil project that aims to ensure no hospice inpatient dies alone. Although many of the hospice’s characteristics are familiar, others are typically Singaporean: inpatients are welcomed with a kopi (traditional coffee) and roti (bread) and the airport is a popular destination for days out.

Singapore’s population mix, primarily ethnic Chinese, Malay and Indian, also means that a variety of before and after death rituals must be catered for. For example, a room is set aside to allow Buddhist patients to be left untouched for up to eight hours after death, the time it takes for the ‘mind’ to leave the deceased’s body.

Whilst service development has been rapid, the acceptance of palliative care sometimes remains a challenge. Strong taboos persist surrounding death and dying. These were apparent before Dover Park hospice was established, when it faced objections from neighbourhood associations about its proposed location; it was eventually constructed in a less residential area. Death taboos also create difficulties discussing the end of life, with many families still preferring to shield patients from full knowledge about their illnesses and prognosis.

Initiatives to raise awareness and encourage open end-of-life discussions include the Agency for Integrated Care (AIC) led ‘Living Matters’ programme. Modelled on the American ‘Respecting Choices’ programme, ‘Living Matters’ focuses on encouraging discussion of end-of-life goals and preferences, rather than specific life sustaining treatment preferences. Special efforts have also been made to provide palliative services to patients with non-malignant conditions. For example, the ‘HOlistic care for MEdically advanced patients’ (HOME) Programme, again led by the AIC, is a palliative home care programme for organ failure patients. Enrolled patients receive a personal care plan, including advance care planning.

Palliative care provision and planning in Singapore is characterized by rapid development and strong coordination and leadership. Although challenges persist, palliative care remains a priority area due to the rapid ageing of Singapore’s population.

Links and further reading

More posts in the South East Asia series on the EAPC Blog…
Click here to read about the ‘Cloud-based Platform for Palliative Care at Home’ by Dr Yingwei Wang from Taiwan. Next in the series will be a post from Dr Rojim J Sorrosa from the Philippines.

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Cloud-based platform for palliative care at home

Dr Yingwei Wang from Taiwan introduces this week’s special series on Palliative Care in South East Asia…

In December 2014, Sheila Payne, Emeritus Professor, International Observatory on End of Life Care, and past president of the European Association for Palliative Care, went to Taiwan to support the development of a new palliative care research network in South East Asia. In Tapei, she took part in the 3rd Building the Collaborative Research Platform and Professional Training Workshop for Cancer Treatment, Hospice/Palliative Care and Bioethics in South East Asian countries and took the opportunity to invite some of the delegates to contribute to this special series that continues this week.

Dr Yingwei Wang, Chief, Lotus Heart Hospice; Tzuchi General Hospital and Department of Medical Humanities at Tzuchi University, Taiwan, explains how modern technology is helping patients to die at home.

Dr Yingwei Wang

Dr Yingwei Wang demonstrating a telephone video consultation

People spend most of their time at home during the last year of their life in Taiwan. Home is the preferred place of death in most cultures, yet many people die in hospital due to various reasons. Studies show that the barriers to providing end-of-life care at home included the non-availability of a 24-hour medical support team, and lack of available medical facilities and resources in the community. In Lotus Heart (Buddhist) Hospice in Taiwan, we have been using modern technology to develop a ‘cloud platform’ to provide the resources that are necessary to enable patients to stay at home, and to supplement the support of competent caregivers.

A recent systematic literature review on home-based palliative care showed that the most frequently reported unmet need was effective communication with healthcare professionals. Yet families rely on the information, advice and support provided by clinicians.

Dr Wang and his team. Also pictured are Prof Sheila Payne ((4th from the left) and Prof Margaret O'Connor (third from right)

Dr Wang and his team. Also pictured are visitors, Prof Sheila Payne, (4th from the left) and Prof Margaret O’Connor (third from right)

The development of the ‘cloud platform’ was based on the needs of patients and caregivers when providing end-of-life care at home. The platform comprises two interfaces (patient/caregiver and health professional) and six modules.

The patient/carer interface includes:

  • Information about caring and the disease process, either in video or booklet format.
  • A medical facilities resource module enabling patients and carers to access the required resources from the community.
  • A collaborative care module enabling patients and carers to find a support group, social network and volunteers through the web-based platform.

The health professional interfaces include:

  • A physiological monitoring module that allows the patient’s physiological condition, e.g. heart rate, blood pressure, blood oxygenation and even tele-stethoscope to be recorded in the cloud medical system. The medical team will be informed automatically of any abnormality in the data.
  • A case management system that includes the input of the subjective symptoms from patient/carer and visual health consultation.
  • A medical integration system integrates the hospital information system and home palliative care system enabling seamless transition between different care settings.
The Taiwan telehospice platform

The Cloud Platform

We have noticed the following positive outcomes since using the cloud platform: a reduction in unplanned admission rates, reduced use of health resources, enhanced communication between clinicians and families, and decreased anxiety on the part of patients and carers.

Some people have questioned the use of physiological monitoring at the end of life but we found that the use of monitoring facilities decreased after one week of the programme. Carers feel safer and more comfortable when caring for dying family members at home. The platform also provides a multilingual system that enables many foreign healthcare assistants to overcome language barriers.

In traditional Chinese culture, dying at home is the ultimate goal for successful life completion. We all know that modern IT cannot replace the compassionate caring by family members. However, the cloud-based platform can improve the quality of care for those who want to stay at home in the final stage of life.

References
Bradford N, Armfield NR, Young J and Smith AC. The case for home based telehealth in pediatric palliative care: A systematic review. BMC Palliative Care 2013, 12:4. (Open access: available to download).

Ventura AD, Burney S, Brooker J, Fletcher J and Ricciardelli L. Home-based palliative care: A systematic literature review of the self-reported unmet needs of patients and carers. Palliat Med 28, no. 5 (2014): 391-402.

Coming up on the EAPC Blog…
Later this week we shall be publishing posts from Dr Rojim J Sorrosa (Philippines) and Dr Natalie Evans (Singapore).

Posted in Medicine, NATIONAL & INTERNATIONAL REPORTS | 1 Comment

EAPC Early Researcher Award: Important acknowledgement to clinicians doing research

On 9 May at the 14th EAPC World Congress in Copenhagen, Dr Tora Skeidsvoll Solheim, Department of Oncology at St Olavs University Hospital/ Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway, received joint-third prize in the 2015 European Association for Palliative Care (EAPC) Early Researcher Award. Here, she describes the inspiration and research that led to this award.

Dr Tora Skeidsvoll Solheim

Dr Tora Skeidsvoll Solheim

I was delighted to receive the EAPC Early Researcher Award at the EAPC World Congress in Copenhagen in May. To have our research acknowledged in this way is a great motivation to take our research projects further. I was introduced to research in palliative medicine by Professor Stein Kaasa, and by means of the EAPC, EAPC Research Network and PRC (European Palliative Care Research Centre). I have participated in several research projects since 2009. The research collaborations in palliative medicine seem to me to be unique in their general openness and willingness to truly collaborate in order to ultimately improve patient treatment, a situation which is not that common in other medical disciplines.

During the past few years I have been balancing the completion of my specialty as a medical and radiotherapy oncologist with the completion of my PhD project, and I now work part time as a consultant in oncology and part time as a researcher. It would be wonderful if other doctors could be motivated by this award and have the chance to take part in palliative care research while working in the clinic. A close collaboration between clinical work and research gives a great opportunity to find out what knowledge is lacking in order to improve clinical care in a very practical manner. There is so much practice in palliative care that is based on tradition and sentiment alone, and we need to enhance the evidence base we base our work on.

Tora Skeidsvoll Solheim (right) with co-chairs of the presentation award ceremony, Carlo Leget and Ole Råkjaer

Tora Skeidsvoll Solheim (right) with co-chairs of the presentation award ceremony, Carlo Leget and Ole Råkjaer

With 2,800 participants from all over the world attending the EAPC World Congress, I also appreciate that winning an Early Researcher Award is a great opportunity to increase the focus on cancer cachexia, my main field of research. We have now conducted several studies in order to improve the understanding of the complex pathophysiology of cachexia and other studies to develop cachexia classifications in order to ultimately improve targeting of patient treatment. Treatment of cachexia is an important unmet need in cancer, with severe impact on mortality and morbidity. Unfortunately, the condition is too rarely addressed, and patients feel this lack of focus from healthcare providers. This causes additional concern and increased anxiety. With Professors Kaasa (Trondheim) and Fearon (Edinburgh) as principal investigators, the European Palliative Care Research Centre is now embarking on an ambitious international intervention study investigating the effect of multimodal treatment for cancer cachexia (MENAC – a randomised, open-label trial of a Multimodal Intervention (Exercise, Nutrition and Anti-inflammatory Medication), plus standard care versus standard care alone to prevent/attenuate cachexia). So far, there is no approved treatment for cachexia that has the ability to improve function and weight, and we are really proud that our research team has now been able to open the MENAC study for inclusion. Results from the feasibility study are not yet published, but we believe that there are grounds for optimism.

Links

More about the EAPC Early Researcher Award
The Early Researcher Award is presented annually by the EAPC and is designed to recognise the work of young (novice) scientists and clinicians in the field of palliative care who have recently made, or are currently making, an outstanding contribution to research. It aims to highlight their personal career development and their potential for the future. Click here to read posts from this year’s prizewinners, Dr Kathy McLoughlin, Dr Julie Kinley and Dr Amara Nwosu.

Look out for announcements about the 2016 Early Researcher Award in the autumn.

Posted in 14th World Congress Copenhagen, EAPC ACTIVITIES, EAPC Congresses, EAPC Early Researcher Awards, RESEARCH | Leave a comment

Mind the gap – health literacy and language level

Today, in Palliative Stories – the EAPC’s special series from the perspective of patients and family carers – we look at how quality of communication is closely related to quality of care.

Clémence Ross is a former Secretary of State for the Ministry of Health, Welfare and Sport and is now a Director of Agora. Agora is an organisation which adopts a palliative approach to care and welfare and has independent expertise on topics related to end of life from the perspective of citizens, patients and their relatives.

Clémence Ross

Clémence Ross

Palliative care in the Netherlands is a task performed by general healthcare practitioners. This can include more or less everything to do with the care provided to terminally ill people. In doing this there is a genuine intention to involve patients and their families in the care process. To achieve this effectively is challenging and difficult. Agora has expertise in the area of patient communication. In addition, we bring the patient’s perspective to the attention of professionals, organisations and government and encourage patient participation.

Patient participation requires not only the skills of professionals. Patients must be able to form a judgment, and to contribute that to the process. That is not always such an easy thing to do. Research shows that one in two Dutch people experiences difficulty in taking full control when it comes to their health, illness and taking care of themselves. Three out of ten adults are not able to obtain health information and to process it. And one in five older people has a low literacy level and little knowledge about health issues.1 All of which is reason enough for Agora to focus on providing accessible communication about palliative care to patients and relatives.

To this end, Agora has set up among other things a nationwide Forum for Communication with Patients about Palliative Care (PPZ is the Dutch acronym). Representatives of patients, clients and relatives participate in this, as well as care organisations and other umbrella or professional organisations. The PPZ Forum has, among other things, contributed to the patient version of the Palliative Care Module. Agora has also released a number of leaflets for patients and relatives in recent years in collaboration with the Forum PPZ. These are written at B1 level (Common European Framework 2). This means that 80% of Dutch people can understand these leaflets. In doing this, we are adhering to the communications directives from the government. From January 1 this year the government is required to communicate at B1 level too.

Reactions from patient organisations to the leaflets have been positive:

“What good news that the folder is now accessible to a wide audience!”

A number of professionals have had to get used to producing texts at a B1 level. Not everyone is aware of differences in language and health literacy levels. Too often, professionals are unconsciously incompetent.

Agora promotes research and further developments in this area – and with positive results. In the Netherlands, patient participation, health literacy and illiteracy are on the political agenda in palliative care!

We would like to hear about your experiences – please leave your comments or email us.

Links and resources

  • Read the factsheet ‘Palliative Care 2014’ for more information about palliative care in the Netherlands or about The Palliative Care Module.
  • Agora.

References
1. Nivel Kennissynthesegezondheidsvaardigheden (2014). 
2. Common European Framework of Reference for Languages.

Read more ‘Palliative Stories’ on the EAPC blog
Next month, Jennifer Fox from Australia will be sharing her story. Click here to read the earlier posts in this series.

If you have a patient, or a family member or friend, who would like to contribute to the series please email the editor.

A message from the EAPC
We would like to thank everyone who has kindly contributed to this series of ‘Palliative Stories’. In publishing patients’ and families’ stories we are aware that content may sometimes focus only on one side of the story but we hope that the stories will help us all to better understand people’s palliative and end of life care experiences. Unfortunately, we are not able to give advice or comment on individual cases but we share in the distress that our contributors have experienced.

 

 

Posted in ADVOCACY & POLICY, Palliative Stories, PATIENT & FAMILY CARE | Tagged | Leave a comment

Coming full circle: Thoughts on winning the European Association for Palliative Care Early Researcher Award

On 9 May at the 14th EAPC World Congress in Copenhagen, Dr Amara Nwosu, Academic Clinical Lecturer in Palliative Care, Marie Curie Palliative Care Institute Liverpool, University of Liverpool, UK, received joint-third prize in the 2015 European Association for Palliative Care Early Researcher Award. Here, Dr Nwosu describes what inspired him to follow a career in palliative care and the research that led to his award.

Dr Amara Nwosu

Dr Amara Nwosu

It is an honour to receive joint 3rd place for the Early Researcher Award of the European Association of Palliative Care. It is important to acknowledge that this is not an award in isolation but represents the support I have received from several individuals.

I am from a medical family; however, this deterred my interest in becoming a doctor as I saw how difficult the job could be. Instead, I decided to go to art school with the intention to do stage design or graphic design. However, my career plans changed because of the care my aunt received in a hospice. Yet initially, as a 16-year-old boy, my experiences with healthcare professionals were generally orientated towards adults rather than children. I was often not included in discussions about my aunt. But my experience in the hospice changed everything. My aunt was dying of breast cancer. The nurse acknowledged me; she asked me: “how are you?” – no one had ever asked me that.

I changed my school subjects (late) to do chemistry, a requirement for medical school (although I still did art!). I was hopeless but did my best. My chemistry teacher, Mr Mercer, kindly provided me with extra tuition in the evenings after school. I somehow got the grades I needed for university. As a student I was fortunate enough to do a research-based student elective in St Louis, Missouri, USA (under the supervision of Professor Kathy Virgo, Professor Frank Johnson and Professor Ricardo Audisio). My interest in research was kindled. Following medical school I completed combined junior clinical academic roles. I decided to come full circle and do palliative care, ending up working in the same hospice where my aunt had died.

Dr Amara Nwosu (right) at the Early Researcher Award presentation Also pictured (from left to right) co-chairs, Carlo Leget and Ole Råkjaer, and joint third-prizewinner,  Tora Skeidsvoll Solheim

Dr Amara Nwosu (right) at the Early Researcher Award presentation. Also pictured (from left to right) co-chairs, Carlo Leget and Ole Råkjaer, and joint third-prizewinner, Tora Skeidsvoll Solheim

Under the supervision of Professor John Ellershaw, at the Marie Curie Palliative Care Institute Liverpool (MCPCIL), I’ve recently completed a PhD evaluating the use of Bioelectrical Impedance Vector Analysis (BIVA) to study hydration states in advanced cancer inpatients based within a specialist palliative care unit in Liverpool, UK. Participating patients were assessed using BIVA, underwent a clinical examination and completed a self-reported symptom questionnaire. This was the first study to use BIVA to objectively assess hydration in advanced cancer and demonstrated how patients with lower levels (compared to those more hydrated) had increased symptom severity, increased intensity of physical signs and shorter survival. Further work is needed to examine the reasons for this difference and to determine whether artificial hydration improves outcomes. Subsequently, I was appointed to the post of Academic Clinical Lecturer in Palliative Medicine at the Marie Curie Palliative Care Institute Liverpool.

It is extremely humbling to receive this award when I look at the calibre of my peers and previous award winners. The EAPC Early Research Award is a wonderful recognition of my work to date. However, you can see that without the support of several people over the years there would be no award for me. Going forward, this award will help me gain confidence in my emergent research skills and will hopefully provide opportunities for collaborative research.

The artist in me is still keen to come out though! Please do check my website for details of my MyPal podcast and other media. Feel free to contact me on Twitter @amaranwosu.

Links

More about the EAPC Early Researcher Award
The Early Researcher Award is presented annually by the EAPC and is designed to recognise the work of young (novice) scientists and clinicians in the field of palliative care who have recently made, or are currently making, an outstanding contribution to research. It aims to highlight their personal career development and their potential for the future.

Click here to read posts from this year’s prizewinners, Dr Kathy McLoughlin and Dr Julie Kinley. Our final post in the ERA series, from Dr Tora Skeidsvoll Solheim, will be published next week.

Look out for announcements about the 2016 Early Researcher Award in the autumn.

 

 

Posted in 14th World Congress Copenhagen, EAPC ACTIVITIES, EAPC Congresses, EAPC Early Researcher Awards, RESEARCH | Tagged | 1 Comment

Identifying palliative and end of life care research priorities in the UK

Dr Sabine Best is Head of Research, Marie Curie, the UK charity that provides care and support for people living with a terminal illness. Here, Dr Best explains the background to a longer article published in the May/June edition of the European Journal of Palliative Care.

Dr Sabine Best

Dr Sabine Best

We recently completed a UK-wide project that identified the top 10 most important research topics to improve palliative and end of life care for people with a terminal illness. This 18-month consultation was a real partnership effort, with 10 organisations co-funding and a total of more than 30 organisations involved in helping with dissemination. It was led by Marie Curie, the UK charity providing care and support for people living with a terminal illness, which is also the largest charitable research funder in this area in the UK.

The process involved two major surveys to identify and then prioritise research questions – more than 1,400 people with a terminal illness, current and former carers, and health and social care professionals took part. A workshop of patient and carer representatives then selected the final 10 from 28 shortlisted questions.

Top of the list was identifying the best ways of providing care outside of working hours to avoid crises and help patients to stay in their place of choice. In second place was looking at how access to palliative care services can be improved for everyone regardless of where they are in the UK. Identifying the benefits of Advance Care Planning and other approaches to listening to and incorporating patients’ preferences was in third place.

A total of 83 research questions, some more specific than others, are included in the final report, which was published in January 2015 . They follow distinct themes, such as Managing Symptoms and Medications, Communication, Support and Service Use, all important areas of concern for patients and carers.

Members of the steering group: Palliative and end of life care Priority Setting Partnership

Members of the steering group: ‘Palliative and end of life care Priority Setting Partnership’ project

The project, which is called the ‘Palliative and end of life care Priority Setting Partnership’, worked with the James Lind Alliance (JLA)  The aim of the JLA is to ensure that the voice of patients, carers and clinicians is heard when setting research priorities. This is important to avoid wasteful health research that has no relevance to what is important to patients and carers (Chalmers and Glaziou, 2009 and Chalmers et al, 2014).

Whilst the main project is finished, we now have to determine how best to address the questions, not only the top 10 but also the whole list of 83 questions. We are looking into how much research is currently in process, which addresses those research questions, and we are considering funding research in partnership with other organisations. We are also continuing to look at the initial survey data to add a qualitative analysis, led by Dr Annmarie Nelson from Cardiff University. We are hoping that there will be many more outputs from this collaborative project.

To follow the progress of the project, look at the project website, view our video film, and/or follow us on Twitter (@PeolcPSP).

Links and references

  • Palliative and end of life care Priority Setting Partnership (PeolcPSP) – Putting patients, carers and clinicians at the heart of palliative and end of life care research, January 2015. 
  • View the video film, ‘The story of the Palliative and end of life care Priority Setting Partnership’
  • Chalmers I and Glaziou P, Avoidable waste in the production and reporting of research evidence, Lancet 374, 86-9 (2009).
  • Chalmers I, Bracken MB, Djulbegovic B, Garattini S, Grant J, Gülmezoglu, Howells DW, Ioannidis JPA and Oliver S, How to increase value and reduce waste when research priorities are set, Lancet 383, 156-165 (2014)

ejpc223coverRead the full article in the European Journal of Palliative Care
This post relates to a longer article, ‘Identifying palliative and end of life care research priorities: a UK approach to consult patients, carers and health and social care professionals, the end users of research’ by Rhiannon Smith, Sabine Best and Bill Noble published in the May/June 2015 issue of the European Journal of Palliative Care (vol. 22.3). If you have a web-based subscription to the journal you’ll be able to download this issue, plus all articles in the journal archive. You can also browse the archive and download articles by taking a 10-minute or 30-minute subscription. Members of the EAPC receive discounted subscription rates to the journal – click here to subscribe online.

Posted in EAPC-LINKED JOURNALS, European Journal of Palliative Care, RESEARCH | Tagged , | Leave a comment

Classifying the invisible: Building a taxonomy of integrated palliative care initiatives

Dr Benjamin Ewert, Research Assistant, University Hospital Bonn, Germany, was one of the speakers in a ‘Meet the expert’ session at the 14th World Congress of the European Association for Palliative Care (May 2015). Here he explains the background to his presentation.

For patients, effective Integrated Palliative Care (IPC) seems almost invisible in practice. Every time I ask study patients how they recognise whether their caregivers work together in a seamless and well-coordinated manner, responses are quite brief and to the point.

‘Building a Taxonomy of Integrated Palliative Care Initiatives’: Dr Benjamin Ewert (centre) sharing some of the results from an expert focus group in the ‘Meet the expert’ session at the 14th EAPC World Congress

‘Building a Taxonomy of Integrated Palliative Care Initiatives’: Dr Benjamin Ewert (centre) sharing some of the results from an expert focus group in the ‘Meet the expert’ session at the 14th EAPC World Congress

“I don’t have to repeat my patient history all over again.” “Services are available just in time,” or “They [professional caregivers] were already informed,” are typical answers from patients acknowledging that different IPC caregivers adapt, apparently smoothly, to their physical and spiritual needs. Thus, integrated care – a term that is not used by patients and their relatives – saves patients from worrying about the organisation and appropriate tailoring of services. In short: Most of them feel, as one patient put it, “comfortable and well cared for”.

This is good news. Evidently, IPC makes a perceptible difference for patients, especially for those who personally experienced fractured and disjointed care in the past. Yet, the major question remains how do we identify IPC initiatives? What are its indispensable features and when is it truly integrated? Within the InSuP-C project we tried to tackle this problem by building a taxonomy (ie a classification scheme) of IPC initiatives across Europe (figure 1).

Figure 1

Figure 1

Our taxonomy, developed under the supervision of a multidisciplinary and international expert group, consists of eight categories, such as level of care and time frame of intervention, including two to four items each, such as primary or early integration. Taken together, the taxonomy encompasses the process of IPC including structure, interaction and time of integration. Integrated palliative care is provided if all categories can be applied and if in at least one of these categories more than one item can be ticked (figure 2); for instance, if an IPC intervention focuses not only on treating patients but also on consulting and advising their care networks.

Figure 2

Figure 2

Does the taxonomy help to compare an IPC initiative in, say, Hungary, to one, in, say, Spain? The scheme was recently tested during a ‘Meet the expert’ session at the 14th EAPC World Congress in Copenhagen. Three groups were tasked to apply the taxonomy on the backdrop of different patient vignettes to IPC initiatives in one country. Results were mixed: On the one hand, facing the variety of existing IPC interventions in Europe participants confirmed the need for a taxonomy. On the other hand, it became clear that the taxonomy might become at best a yardstick against which different IPC concepts and principles could be presented.

The expert session taught us that the template could be used as a toolkit for policymakers and professional caregivers to enhance their knowledge of IPC and to think about their own services. But a refinement of the taxonomy – based on practical experience – needs further attention in the future.

Links and resources

  • More about InSuP-C on the InSuP-C project website.
  • Read more posts on the EAPC Blog about Integrated Palliative Care and InSuP-C.
  • Click here for more pictures of the 14th EAPC World Congress and to view or download the Book of Abstracts.

 

Posted in 14th World Congress Copenhagen, EAPC ACTIVITIES, EAPC Congresses, InSup-C (integrated palliative care) | Tagged , | Leave a comment