Professor Anica Jusić Obituary: Neurologist and pioneer of palliative care in Croatia

Professor David Oliver, Tizard Centre, University of Kent, Canterbury, United Kingdom and Chair of the European Association for Palliative Care (EAPC) Neurology Reference Group, remembers the contribution of neurologist Professor Anica Jusić, who was a driving force for palliative care in Croatia.

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Professor Anica Jusić with David Oliver in 2018

Professor Anica Jusić died on 5 December 2021 at the age of 95.  She had spent more than 30 years fighting for the development of palliative care in Croatia – an aim that is being achieved now with palliative care services developing across the country and palliative care included within national and local plans.

Professor Jusić had been a renowned neurologist and was chair of the Institute for Neuromuscular Diseases in Zagreb from 1978 to 1991. One of her areas of interest had been in the care of people with amyotrophic lateral sclerosis (ALS) and spinal amyotrophies. She was well aware that often there was no treatment she could give and she spoke of how “we could not help them and we could not keep them on the ward either, as there was a shortage of beds”. In 1989, she organised a scientific workshop on ALS and she heard about the role of palliative care for neurological patients. She attended the first International Symposium on ALS in Solihull in the UK and went on to visit St Christopher’s Hospice in London. There she met Dame Cicely Saunders and was able to visit the wards and see people with ALS being cared for at the hospice. This approach is what she had been seeking and she started her ‘second life’ – as an advocate for palliative care.

During the coming years the foundations of palliative care were laid – with the formation of the Croatian Society for Hospice and Palliative Care in 1994, the Friends of Hope Association in 1997, the Hospice Friends in 1999 and the Croatian Association for the Treatment of Pain in 2000.

I first met Professor Jusić at an international meeting about palliative care in Poland.  We talked of her aims of developing services in Croatia and at that time I was establishing a new Masters course in palliative care at the University of Kent. In 2000, Professor Jusić invited me to speak on ALS at a neurological meeting in Zagreb in Croatia and the collaboration started. A multidisciplinary group of teachers from the University of Kent visited Zagreb over the next few years. We led sessions on the principles of palliative care and a group of enthusiasts was formed.  They helped to set up a home care service in Zagreb, but as this was on a voluntary basis the service was only able to continue for a few years. However, the seeds were sown, and the Croatian Ministry of Health set up a committee, chaired by Professor Jusić, to help develop services.

Over the years, palliative care has slowly developed in Croatia and I have continued to visit regularly – speaking at sessions in Zagreb and other parts of Croatia. I have also been the co-ordinator for an elective course on palliative care within the English Curriculum at the Medical Faculty in Zagreb. I always looked forward to meeting up with Professor Jusić and having a meal with her at her flat. Even as she became frailer, she would always have new ideas for a publication. In 2020, I collaborated with her to facilitate the publication of one of her final publications – a blog post on the use of Nordic walking in Parkinson’s disease, which came out of her own personal experience of coping with Parkinsonism. The post received more than 5,000 views and is available here: https://blogs.bmj.com/spcare/2020/12/04/the-experiences-of-a-neurologist-with-parkinsonism/  Her mind remained very active, and she was so proud when her autobiography was published – looking at her ‘two lives’ as a neurologist and in palliative care.

Professor Anica Jusić will be greatly missed – by her family, colleagues and collaborators.  She helped to establish the foundations of palliative care in Croatia and the new services are a testament to her determination to improve the care of people with progressive illness.

Links and further reading

• Contact Professor David Oliver by email.
• Jusic A. Dva Zivota Anice Jusic: Razvoj neurologije hospicijskog pokreta u harvatskoj tijekom druge polovine 20. Stoljeca. (The two lives of Anica Jusić) 2015. Zagreb. Hrvataska Akademija Znanosti I Umjetnosti
• Jusic A, Oliver D. Establishing palliative care in Croatia: memories of a pioneer. Eur J Pall Care 2016; 23: 196-199. *
• Oliver D, Murtagh F, Jusic A. Palliative care in Croatia- and international collaboration. Eur J Pall Care 2005; 12: 127-129. *
• Read more about Neurology and Palliative Care in a special series that is currently running on the EAPC blog hosted by the EAPC Neurology Reference Group. See also posts on Palliative Care in Croatia on the blog.

Editorial note: * The two articles published in the European Journal of Palliative Care (EJPC) may be viewed in the EJPC open archive. Click here to register and access the archive. (You may need to choose the year, issue and article before you register). Registration is free and only requires an active email account.

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