Palliative Care Implementation in Veterans’ Long-Term Care Facilities in Taiwan: Review of an international online seminar

Integrated Hospice Palliative Care Network for Veterans in Taiwan (IHPCNVT) hosted an international online seminar in October 2021 to discuss Palliative Care Implementation in Long-Term Care Facilities. Po-Chin Yang, Shu Kao, Hsiao-Ting Chang and Ming-Hwai Lin from the Taipei Veterans General Hospital, Taiwan explain more.


Dr Po-Chin Yang, Dr Hsiao-Ting Chang, Shu Kao, Dr Ming-Hwai Lin

In Taiwan, the concept of palliative care has gained more and more attention in recent years and all terminally ill patients can choose to receive palliative care. The types of hospice care currently offered in Taiwan include in-patient hospice care (hospice wards), hospitals consultation/combined care, hospice home care, and community hospice care. Since 1996, the National Health Insurance has covered hospice home care for patients with terminal cancer, making it easy and affordable for those in need, and the service gradually incorporated in-patient care. Then, in 2009, the National Health Insurance service was expanded to include eight types of non-cancer end-stage diseases, enabling more patients to receive hospice and palliative care. By 2021, there were 82 hospitals providing in-patient hospice care, 160 hospitals providing palliative care services hospitals consultation/combined care and 126 hospitals providing hospice home care in Taiwan. In a recently published paper, Taiwan ranked third among many countries that received the highest assessment scores for end-of-life care.(1) How to improve service quality is also the goal of continuous efforts for our palliative care community.

Veterans in Taiwan means retired servicemen and women. As a measure of gratitude to these warriors who have sacrificed and given so much for the country, the government confers upon these veterans the title which is close to ‘honoured citizens’. Veterans Affairs Council is an organisation that specialises in handling the major issues of veterans in Taiwan, including the provision of long-term care. It currently provides three Veterans’ general hospitals, 12 general hospital branches, and 16 Veterans’ Homes with more than 8,000 beds providing acute care, intermediate care and long-term care for veterans. Since the first home was established in 1953, Veterans’ Homes have cared for thousands of veterans and they are now the largest long-term care service system in Taiwan.

In response to the government’s plan to implement hospice and palliative care for veterans living in the community and in Veterans’ Homes, the Veterans Affairs Council funds the ‘Integrated Hospice Palliative Care Network for Veterans in Taiwan’ (IHPCNVT) which provides support at the end of life and protects veterans’ rights to a peaceful death.

The IHPCNVT is committed to promoting hospice palliative care in long-term care facilities. The network has accumulated a lot of experience, but also encountered many obstacles. In view of this, they held an international online seminar on October 1, 2021, with the theme ‘Palliative Care Implementation in Long-Term Care Facilities’.

Experiences shared at the online seminar

Professor Sheila Payne was interviewed during the seminar. She shared the experience of promoting palliative care in long-term care facilities and introduced the European Association for Palliative Care White Paper Palliative Care Implementation in Long-Term Care Facilities to the audience.

Professor Payne described the transition policy for caring for end-of-life residents where there is a strong policy drive to help older people stay in the familiar environment of their nursing homes at the end of life. For this, she encouraged family members and healthcare workers to communicate with residents (including, as far as possible, those with dementia) to open up conversations about personal preferences and advance care planning. She also emphasised the importance of empowering and supporting nurses and care assistants in nursing homes. Finally, Professor Payne introduced the Massive Open Online Course (MOOC) called Improving Palliative Care in Care Homes, which lets people in different regions of the world learn about palliative care knowledge.

Another invited speaker, Professor Geoffrey Mitchell from Australia, shared the experience of identifying palliative care needs in residential care. Dr Ming-Hwai Lin from the Taipei Veterans General Hospital also shared the experience of promoting palliative care in Veterans’ Homes, referencing the steps of the European Palliative Care for Elderly (PACE) programme.

The international seminar ‘Palliative Care Implementation in Long-Term Care Facilities’ ended successfully. Meanwhile, the Integrated Hospice Palliative Care Network for Veterans in Taiwan will continue to work hard to promote hospice palliative care to meet people’s needs and to provide a full range of high-quality services.


Reference

1 Finkelstein et al, Cross Country Comparison of Expert Assessments of the Quality of Death and Dying 2021, Journal of Symptom Pain and Management. First available online 22nd December 2021.

Links and resources

About the authors 

Po-Chin Yang, MD, Attending Physician at the Department of Family Medicine, Taipei Veterans General Hospital, Specialty in Hospice Palliative Medicine. Adjunct Instructor at School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.

Shu Kao, MSc Psychology, clinical psychologist at the Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. She now participates in the hospice combined care, home hospice care and advanced care planning teams.

Hsiao-Ting Chang, MD, PhD, Director of Division of Hospice Palliative Medicine, Taipei Veterans General Hospital. Specialty in Hospice Palliative Medicine. Adjunct Associate Professor of School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.

Ming-Hwai Lin, MD, Director of the Department of Family Medicine, Taipei Veterans General Hospital. Specialty in Hospice Palliative Medicine. Adjunct Associate Professor at School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.


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This entry was posted in EAPC COLLABORATIVE PROJECTS, EDUCATION & TRAINING, NATIONAL & INTERNATIONAL REPORTS, PACE, PATIENT & FAMILY CARE and tagged . Bookmark the permalink.

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