Palliative care for older people - World Health Organization ...

6Educational interventionsA well-performing workforce is a buildingblockof health systems identified by WHO’sframework for action in strengthening healthsystems, and education is a key component ofproviding palliative care. An interprofessional,multidisciplinary approach towards learning andcommunication at all levels of care is neededto meet the complex needs of older people.Most educational interventions focus on addingpalliative care concepts to current curriculafor undergraduate and postgraduate medicalstudents. Physicians may lack formal education inpalliative care in some countries (such as Ireland).Integrating the principles of palliative care in thisway is relatively inexpensive and time efficient.Fewer palliative care educational interventionshave targeted nurses, nursing students, nurseeducators or other workers (such as care assistants)and volunteers, who are often directly involved inproviding care.The educational opportunities for nurses varywidely between countries, reflecting the positionof the nursing profession. Although nurses in manyEU countries are able to access some education inpalliative care, this may differ between the westernand eastern parts of the WHO European Region.Professional health care providers, informalcaregivers, people receiving care and the generalpublic would benefit from better understandingpalliative care and end-of-life issues. Peer educatorscould be a cost-effective way of providing this(Box 6.1). One problem appears to be lack oftraining in managing pain and other symptomsand reluctance to use opioid drugs (when theseare available) outside specialist settings. This canbe addressed by expanding education and trainingfor staff providing care in all settings, includingresidential and nursing homes as well as hospitals© Maria Rosaria Sumaand people’s own homes (Box 6.2). Another issueconcerns the wide variability in roles, competenciesand education of professionals in palliative carein countries in the European Region. One way totackle this is to develop core common curricula fortraining through initiatives at the European Regionlevel (Box 6.3).There are synergies between geriatric nursing,palliative care and dementia care skills, whichcould be further explored for education in thefuture. Older people with complex needs requirecombinations of all three and are underserved interms of all three skill sets.21