scholarly journals Primary palliative care for older people in three European countries: a mortality follow-back quality study

2019 ◽  
Vol 10 (4) ◽  
pp. 462-468 ◽  
Author(s):  
Kim de Nooijer ◽  
Lara Pivodic ◽  
Luc Deliens ◽  
Guido Miccinesi ◽  
Tomas Vega Alonso ◽  
...  
Keyword(s):  
Palliative Care ◽  
Older People ◽  
Patient Communication ◽  
European Countries ◽  
Epidemiological Surveillance ◽  
Palliative Care Services ◽  
Complex Health Problems ◽  
Almost All ◽  
Care For Older People

BackgroundMany older people with serious chronic illnesses experience complex health problems for which palliative care is indicated. We aimed to examine the quality of primary palliative care for people aged 65–84 years and those 85 years and older who died non-suddenly in three European countries.MethodsThis is a nationwide representative mortality follow-back study. General practitioners (GPs) belonging to epidemiological surveillance networks in Belgium (BE), Italy (IT) and Spain (ES) (2013–2015) registered weekly all deaths in their practices. We included deaths of people aged 65 and excluded sudden deaths judged by GPs. We applied a validated set of quality indicators.ResultsGPs registered 3496 deaths, of which 2329 were non-sudden (1126 aged 65–84, 1203 aged 85+). GPs in BE (reference category) reported higher scores than IT across almost all indicators. Differences with ES were not consistent. The score in BE particularly differed from IT on GP–patient communication (aged 65–84: 61% in BE vs 20% in IT (OR=0.12, 95% CI 0.07 to 0.20) aged 85+: 47% in BE vs 9% in IT (OR=0.09, 95% CI 0.05 to 0.16)). Between BE and ES, we identified a large difference in involvement of palliative care services (aged 65–84: 62% in BE vs 89% in ES (OR=4.81, 95% CI 2.41 to 9.61) aged 85+: 61% in BE vs 77% in ES (OR=3.1, 95% CI 1.71 to 5.53)).ConclusionsConsiderable country differences were identified in the quality of primary palliative care for older people. The data suggest room for improvement across all countries, particularly regarding pain measurement, GP–patient communication and multidisciplinary meetings.

scholarly journals Quality of primary palliative care for older people with mild and severe dementia: an international mortality follow-back study using quality indicators

2018 ◽  
Vol 47 (6) ◽  
pp. 824-833 ◽  
Author(s):  
Rose Miranda ◽  
Yolanda W H Penders ◽  
Tinne Smets ◽  
Luc Deliens ◽  
Guido Miccinesi ◽  
...  
Keyword(s):  
Palliative Care ◽  
Older People ◽  
Quality Indicators ◽  
Severe Dementia ◽  
Care For Older People

Palliative care in old age

2006 ◽  
Vol 16 (1) ◽  
pp. 35-44 ◽  
Author(s):  
Raymond SK Lo ◽  
Jean Woo
Keyword(s):  
Palliative Care ◽  
Older People ◽  
Old Age ◽  
Physical Symptoms ◽  
Chronic Illnesses ◽  
List Type ◽  
Life Issues ◽  
Review Current ◽  
Care For Older People

With an aging population globally, and increasing numbers of older patients facing chronic illnesses, better palliative care in old age should be promoted.In this review we will Highlight the pressing need for better palliative care for older peopleAdvocate the concept of palliative care as applied to geriatrics and gerontologyReview current end-of-life care for older people with chronic disease, both non-cancer and cancerDiscuss the palliative-care approaches to common physical symptoms and psychospiritual distressHighlight advanced care planning and quality-of-life issues

scholarly journals Palliative care competencies for geriatricians across Europe: a Delphi consensus study

2021 ◽  
Author(s):  
Sophie Pautex ◽  
◽  
Regina Roller-Wirnsberger ◽  
Katrin Singler ◽  
Nele Van den Noortgate
Keyword(s):  
Palliative Care ◽  
Older People ◽  
Rating Scale ◽  
Geriatric Medicine ◽  
Delphi Consensus ◽  
Modified Delphi ◽  
Postgraduate Level ◽  
Modified Delphi Technique ◽  
Care For Older People

Abstract Purpose Integration of palliative care competencies with geriatric medicine is important for quality of care for older people, especially in the last years of their life. Therefore, knowledge and skills about palliative care for older people should be mandatory for geriatricians. The European Geriatric Medicine Society (EuGMS) has launched a postgraduate curriculum for geriatric medicine recently. Aim Based on this work, the Special Interest Group (SIG) on Palliative care in collaboration with the SIG in Education and Training aimed to develop a set of specific palliative care competencies to be recommended for training at a postgraduate level. Methods Competencies were defined using a modified Delphi technique based upon a Likert like rating scale. A template to kick off the first round and including 46 items was developed based on pre-existing competencies developed in Switzerland and Belgium. Results Three Delphi rounds were necessary to achieve full consensus. Experts came from 12 EU countries. In the first round, the wording of 13 competencies and the content of 10 competencies were modified. We deleted or merged ten competencies, mainly because they were not specific enough. At the end of the 2nd round, one competence was deleted and for three questions the wordings were modified. These modifications had the agreement of the participants during the last round. Conclusion A list of 35 palliative care competencies for geriatricians is now available for implementation in European countries.

But does it work? The role of regulation in improving the quality of residential care for older people in Europe

2015 ◽  
Vol 16 (2) ◽  
pp. 118-128 ◽  
Author(s):  
Ciara O'Dwyer
Keyword(s):  
Older People ◽  
Residential Care ◽  
Command And Control ◽  
European Countries ◽  
Comparative Approach ◽  
Content Type ◽  
Financial Investment ◽  
And Control ◽  
Care For Older People

Purpose – Regulation is the tool preferred by policy-makers to manage the quality of residential care for older people. However, it remains unclear which form of regulation is most effective. The residential care sector for older people in Europe offers a unique opportunity to explore this issue as countries vary in how they control quality in the sector. The paper aims to discuss this issue. Design/methodology/approach – The study used a comparative approach, collating secondary data from various sources and conducting qualitative comparative analysis on the data. Findings – Three regulatory approaches were in operation – many Northern European countries operate on a self-regulatory basis, and are associated with the highest quality. Many continental countries, the UK and Ireland operate a command-and-control regulatory approach, with a moderate standard of care. Mediterranean and Eastern European countries have limited regulation, with care of a lower standard. However, the type of regulation appears to be a product of the prevailing culture and philosophy of care within each country. Thus, quality outcomes are a measure of financial investment in care. Social implications – Consistent calls for command-and-control style regulation may be misguided; high-quality care requires high-public investment and a professional workforce with the freedom to focus on quality improvement mechanisms. Originality/value – The paper provides a framework for analysing outcomes associated with different types of regulation. While a self-regulatory model is linked with the best outcomes, financial investment and the philosophy of care may be more important factors influencing the quality of care.

scholarly journals The importance of addressing ageism in Swedish healthcare

2020 ◽  
Vol 40 (3) ◽  
pp. 113-115
Author(s):  
Katarina Sjögren Forss
Keyword(s):  
Older People ◽  
Health Inequalities ◽  
European Countries ◽  
Or Groups ◽  
Significant Class ◽  
Care For Older People

Ageism is discrimination against individuals or groups based on their age. In the Swedish healthcare context, the term is uncommon, despite the fact that older people are a significant class of users. One of every five individuals in Sweden is 65 years of age or older, and the proportion of older people in the population is rising. Therefore, ageism in healthcare warrants more awareness and focus. In three recent articles that we have published relating to nutritional, depression and continence care for older people, we found indications of ageism even though we did not aim to study it. There is a need to identify the manifestations of ageism and label them, and to become alert to both the visible and invisible expressions of ageism. This will help in the development of interventions and policies to eliminate ageism in healthcare. With health inequalities growing and seemingly becoming the norm rather than the exception in Sweden and other European countries, it has become imperative to address and eliminate health inequalities through a range of initiatives and mechanisms. Fighting ageism in different settings must be a part of this larger goal.

scholarly journals Identifying Palliative Care Needs in Assisted Living

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 788-788
Author(s):  
Daniel David ◽  
Abraham Brody ◽  
Tina Sadarangani ◽  
Bei Wu ◽  
Tara Cortez
Keyword(s):  
Palliative Care ◽  
Assisted Living ◽  
Unmet Needs ◽  
Care Needs ◽  
Code Status ◽  
Care Services ◽  
Palliative Care Services ◽  
Advance Care ◽  
Palliative Care Needs

Abstract Many residents of Assisted Living (AL) confront serious illness and therefore might benefit from greater access to Palliative Care Services to improve quality of life. We surveyed resident records and AL nursing staff to identify patients in need of Palliative Care. Preliminary findings showed that nurses predicted 23% would not be alive and 49% would no longer live in AL. A majority of residents were over the age of 90, yet 30% did not have a reported code status. These findings suggest that a substantial portion of AL residents may have unmet needs with respect to palliative care. Future interventions are needed to support advance care planning conversations and make palliative care more accessible to this population.

Interventions for improving palliative care for older people living in nursing care homes

2008 ◽  
Author(s):  
Sue Hall ◽  
Anna Kolliakou ◽  
Elizabeth A Davies ◽  
Katherine Froggatt ◽  
Irene J Higginson
Keyword(s):  
Palliative Care ◽  
Older People ◽  
Nursing Care ◽  
Care Homes ◽  
Care For Older People
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