EAPC Atlas of Palliative Care in Europe 2019

EUROPEAN CONTEXT
Chapter 7. Integration of Palliative Care
in Long-Term Care Facilities in 18 European countries
B
TechnicaL data
ON THE 2019 EAPC
SURVEY ON
PALLIATIVE CARE IN
LONG-TERM FACILITIES
Population: 54 countries of the
Europe WHO region and Lichtenstein.
Survey Details
Areas explored: 7 main indicators
for long-term care facilities
(LTCFs): Existence of official documents
regulating PC interventions
and its provision; training
in PC; publications regarding
the provision of PC; collaboration
with PC teams; availability of
national funds.
Questionnaire: on line survey, 17
questions, answered in (average):
27 minutes.
Participants: 25 national
experts: 6 identified in the EAPC
TaskForce on LTCFs or EAPC
report, 5 in LTCF-related publications,
9 recommended by PC
experts and remaining 5 are from
Universities, PC research centres,
or PC services´ contexts.
Coverage: 18/54 countries
(33%): with two respondents or
over in 5/18 countries (28%),
and one respondent in 13/18
countries (72%).
Data collection: 12/2018 to
3/2019 (4 months).
Project Management: ATLANTES
Research Group, Institute for Culture
and Society, University of Navarra,
Pamplona (Navarra), Spain .
Scientific Advice: Katherine Froggatt
(UK) and Lieve Van den Block
(Belgium).
Promotor: European Association
for Palliative Care (EAPC).
Long-term care facilities are collective institutional settings in
which care is provided to older people on-site 24 hours a day, 7 days
a week, including facilities with on-site and off-site nurses and medical
staff. This term includes a range of facilities offering different
levels of social and health care (Froggatt et al, 2017).
The first study on how palliative care
(PC) is integrated into Long Term Care
Facilities (LTCFs) in Europe was developed
in 2013 by the European Association
of Palliative Care (EAPC) (1). Thereafter, in
2015, the PACE project (Comparing the effectiveness
of PATIENT CARE for older people in LTCFs)
provided an overview of mapping PC systems in
LTCFs in Europe (2). This chapter intends to evaluate
the current state of PC integration into LTCFs
in the WHO European Region building on previous
experiences through the use of similar indicators.
PC provision in LTCFs
LTCFs can seek advice from Palliative Care teams
to better address the patient in terms of pain
and symptom management, specific needs
and family support. In Europe, this collaboration
between PC teams and LTCFs staff varies
in its frequency. Lithuania and Kyrgyzstan report
that cooperation “always” exist in their practice,
at the time that Belgium and Austria also consider
that this partnership happens “most of the
time”. Countries such as the Czech Republic,
Israel, Russia, Italy, and Armenia admit a hardly
often to non-existent/never collaboration frequency.
A vast majority of European countries
though (9/18) point out occasional collaborations
(Greece, Denmark, Poland, The Netherlands,
France, Switzerland, UK, Germany, Spain).
Regulation of PC provision in LTCFs
Palliative Care provision is often regulated by
documents with national validity, usually referring
to structural features that should be available
in LTCFs such as personnel, beds, materials,
etcetera. Ten European countries inform
having national strategies, plans or policies,
Carla Reigada , Katherine Froggatt, Lieve Van den Block.
and eight state having standards of quality provision
of PC services. Likewise, 11/18 countries
report having some sort of guidelines or protocols,
either as official protocols (four countries)
or other non-official documents actually modulating
palliative care provision in long-term care
facilities in the country.
Funding For PC provision in LTCFs
Less than half of reporting countries (7/18)
inform having national funding available to
support the provision of Palliative Care in LTCFs.
Funding models vary from grants, prizes and
loans, to the reception of an annual economic
support. Specifically, five countries state getting
an annual national support which occur in different
ways. Some countries have a contract with
the National Health Fund and get a donation for
hospices, others report having regional economic
rates from regional health and social-care funds,
or others where PC at LTCFs is entirely public.
PC training in LTCFs
The estimation of LTCFs staff with PC training is
over 90% in Lithuania, followed by Kyrgyzstan,
Poland, The Netherlands, Belgium, France, Switzerland
and the UK (ranging from 40% to 90%).
Half of the reporting countries do not reach a
40% ratio in terms of staff´s PC training. Furthermore,
12/18 countries confirm the existence of
national studies on the provision of PC in LTCFs
and another seven countries declare their participation
in an international project on PC provision
in LCTFs (Lithuania, Belgium, Poland, The
Netherlands, Switzerland, UK, Italy).
EAPC Atlas of Palliative Care in Europe
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