Palliative care provision in long-term care facilities differs across Europe: Results of a cross-sectional study in six European countries (PACE). (October 2019)

• Record Type: Journal Article
• Authors: ten Koppel, Maud; Onwuteaka-Philipsen, Bregje D; Van den Block, Lieve; Deliens, Luc; Gambassi, Giovanni; Heymans, Martijn W; Kylänen, Marika; Oosterveld-Vlug, Mariska G; Pasman, H Roeline W; Payne, Sheila; Smets, Tinne; Szczerbińska, Katarzyna; Twisk, Jos WR; van der Steen, Jenny T
• Other Names: Groote Zeger De non-byline-author.; Mammarella Federica non-byline-author.; Mercuri Martina non-byline-author.; Pivodic Lara non-byline-author.; Pac Agnieszka non-byline-author.; Rossi Paola non-byline-author.; Segat Ivan non-byline-author.; Sowerby Eleanor non-byline-author.; Stodolska Agata non-byline-author.; van Hout Hein non-byline-author.; Wichmann Anne non-byline-author.; Adang Eddy non-byline-author.; Andreasen Paula non-byline-author.; Finne-Soveri Harriet non-byline-author.; Collingridge Moore Danni non-byline-author.; Froggatt Katherine non-byline-author.; Kijowska Violetta non-byline-author.; Van Den Noortgate Nele non-byline-author.; Vernooij-Dassen Myrra non-byline-author.
• Is Part Of: Palliative medicine. Volume 33:Number 9(2019)
• Page Start: 1176
• Page End: 1188
• Publication Date: 2019-10
• Subjects: Nursing homes -- palliative care -- residential facilities -- long-term care -- aged 80 and over -- aged -- cross-sectional studies -- retrospective studies; Pain -- Treatment -- Periodicals; Cancer -- Palliative treatment -- Periodicals; Palliative Care -- Periodicals; Palliatieve behandeling; 616.029
• DOI: 10.1177/0269216319861229
• Languages: English
• ISSNs: 0269-2163

Abstract

Background: While the need for palliative care in long-term care facilities is growing, it is unknown whether palliative care in this setting is sufficiently developed. Aim: To describe and compare in six European countries palliative care provision in long-term care facilities and to assess associations between patient, facility and advance care planning factors and receipt and timing of palliative care. Design: Cross-sectional after-death survey regarding care provided to long-term care residents in Belgium, England, Finland, Italy, the Netherlands and Poland. Generalized estimating equations were used for analyses. Setting/participants: Nurses or care assistants who are most involved in care for the resident. Results: We included 1298 residents in 300 facilities, of whom a majority received palliative care in most countries (England: 72.6%–Belgium: 77.9%), except in Poland (14.0%) and Italy (32.1%). Palliative care typically started within 2 weeks before death and was often provided by the treating physician (England: 75%–the Netherlands: 98.8%). A palliative care specialist was frequently involved in Belgium and Poland (57.1% and 86.7%). Residents with cancer, dementia or a contact person in their record more often received palliative care, and it started earlier for residents with whom the nurse had spoken about treatments or the preferred course of care at the end of life. Conclusion: The late initiation of palliative care (especially when advance care planning is lacking) and palliative care for residents without cancer, dementia or closely involved relatives deserve attention in all countries. Diversity in palliative care organization might be related to different levels of its development.