Katherine Froggatt, Professor of Ageing and Palliative Care, International Observatory on End of Life Care, Faculty of Health and Medicine, Lancaster Univiversity, UK, and Lieve Van den Block, Professor of Ageing and Palliative Care, VUB-UGent End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
We are pleased to report that the second EAPC Taskforce looking at palliative care in long-term care facilities (LTCFs) in Europe has just been completed. The taskforce work was undertaken as part of the EUFP7 funded PACE study (PACE –comparing the effectiveness of PAlliative CarE for older people in long-term care facilities in Europe). See the PACE website.
Within the work of this most recent taskforce, we have engaged with 29 European countries, building upon the work of the previous taskforce that considered palliative care provision in 13 European countries. This first report is available here.
The aim of the current taskforce was to map and classify different structures, organisational models, and policies related to palliative care provision in LTCFs in Europe. Through a survey of country informants and a review of secondary data sources, we have built up a picture of the long-term care facility context and the different ways in which palliative care is being developed and provided in this setting.
As part of this work, we have developed a typology of palliative care implementation in this setting for the European context. This has been accepted for publication in JAMDA (Journal of the American Medical Directors Association) – see link below. In this paper, we identify three levels of implementation drivers: macro (strategic), meso (operational) and micro (organisational). Strategic factors were nationally and or regionally present and concerned policy, legislation and financial and regulatory drivers. At an operational level, implementation activities such as education, the promotion of tools/frameworks, new service models and research supported the implementation of palliative care in LTCFs. This was then manifested in the extent to which palliative care was delivered in LTCFs in any country. Both strategic and implementation activity is usually required to ensure ongoing, sustained palliative care provision in LTCFs.
We will continue to face challenges in order to ensure the delivery of palliative care in LTCFs in a consistent and high-quality way. These challenges lie in ensuring that national policies, funding, regulatory and quality assurance frameworks specifically address palliative care for older people in LTCFs. This then needs to be supported by appropriate implementation approaches at more local and organisational levels to ensure staff are equipped to deliver palliative care with appropriate resources and support from within, and externally, to LTCFs. The new typology will enable a more structured consideration of where effort could be directed to ensure ongoing palliative care provision in LTCFs.
As before, we are very grateful to the people who acted as country informants to provide us with information about the long-term care sector and palliative care initiatives in their respective countries.
To find out more
- To access the full report PACE/EAPC Taskforce report, follow this link (and scroll to the end of the page).
- To access the paper in JAMDA, follow this link.
Members of PACE will be presenting Palliative care in Long-term Care Facilities in Europe: State of the Art (EU-funded PACE project) on Friday 19 May 2017 – 16h45 to 18h15 (N101-N102), chaired by Lieve Van den Block and Sophie Pautex.
- 16h45: Mapping palliative care development in long-term care facilities in 29 European countries – Katherine Froggatt
- 17h15: Quality of care and quality of dying in care homes in six EU countries: results of the epidemiological study of the PACE project – Lara Pivodic
- 17h45: Integrated palliative care in long-term care facilities: Research challenges in a cluster RCT in Europe – Bregie Onwuteaka-Philipsen.
To view the full congress programme and to register, please visit the congress website.