On 15 October, outcomes of two European research projects, IMPACT and EUROIMPACT, were presented at the conference ‘Towards integration of palliative care in an age-friendly EU’ in Brussels. Both projects aim to increase research and workforce training, to look at the integration in different care settings, at processes and outcomes of palliative care.
Palliative care is, according to the WHO definition, “an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and treatment of pain and other problems, physical, psychosocial and spiritual.”
Why palliative care?
Researchers at the conference emphasised that a holistic model of palliative care is needed in an ageing society. Although we live longer, older adults are very likely to have one or more diseases, and therefore complex and multiple needs as well. By 2015, one in three people over 65 will die with dementia in the UK. Because of the likelihood of developing one or more diseases or long-term conditions over a certain period of time, palliative care should not focus only on cancer and terminal stage patients.
People with multi-morbidities account for half of health care costs and the provision of palliative care impacts on costs in terms of fewer hospital admissions. Sean Morrison from the National Palliative Care Research Center in the US noted in his presentation: “Multiple studies show that interdisciplinary services reduce pain and address personal goals and family satisfaction. They also reduce health care costs because they allow care according to patients’ goals in more appropriate settings.”
Challenges for health and social services
Palliative care is an interdisciplinary approach provided by an inter-professional team, consisting of health and social care professionals in different care settings, such as hospitals, care homes and patients’ homes. This personalised care should be available 24/7. However, this proves to be a challenge for services to set up, particularly for frail older people, according to Lukas Radbruch, Director of the Palliative Care Centre in Germany. Many participants at the conference underlined that the provision of palliative care is linked with workforce training and a need to invest in research. Training and research should focus on the development of community-based support in cooperation with nursing homes, home services and primary health care.
Many participants also addressed the fragmentation between the health and social sector and the focus on a cure of most health systems. In order to provide personalised care for people with one or more life-threatening illness, cooperation across sectors within the community and with informal carers is necessary. For example, social care workers could be trained to coordinate different services and make palliative care accessible. Kai Leichsenring from the European Centre for Social Welfare Policy and Research added: “The health care system focuses on curing diseases and is successful in this, however, allies for palliative care are in the field of long term care and not health care.”
The European Social Network (ESN) will look at policies and practices of cooperation between the health and social care during our next Ageing and Care working group meeting, when we will consider how to support people with severe care needs.