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

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Box 6.1. Peer education for advance care planningThis project aimed to raise awareness about treatment and care choices at the end of life among older adultsliving in the community in Sheffield, United Kingdom. Academic researchers and people recruited fromvoluntary groups representing older adults acted as community advisers, with some assuming the role of peereducator. A booklet was designed to prepare the peer educators to facilitate learning sessions, covering suchissues as bereavement and loss, palliative care and ethical and legal issues. Three days of training was provided.Some of the older people involved appreciated the experience of working collaboratively with other researchersand being peer educators. An extension of the project was completed in September 2009, with 30 peoplebecoming volunteer peer educators. Publications and wider dissemination of the model are underway.Source: Sanders et al. (1).Box 6.2. Training the trainersThese courses (MSc, Postgraduate Diploma and Certificate in Palliative Care) have been designed to developfuture leaders in palliative care (2). Participants from all over the world develop the skills necessary to appraiseresearch and evidence on palliative care and to improve clinical practice and lead services. The course stronglyemphasizes diseases other than cancer and includes sessions on palliative care in nursing homes. A follow-upof career trajectories on completion of the course found increased involvement in a wide range of clinical,research and service development activities, including research, needs assessment, quality assurance and policydevelopment. Participants felt that the course helped develop lateral thinking, challenged misconceptionsand enhanced teamwork opportunities, professional networks and confidence and improved their chances ofpromotion.Those completing the course then go on to train others in their countries and regions, disseminating skillsand knowledge in palliative care more widely. The costs of running the course include a half-time coursecoordinator, a half-time course administrator and fees for visiting lecturers. Participants have to pay fees toattend, but charities or governments increasingly provide funds for this.Source: Koffman & Higginson (3).22
Box 6.3. European Association for Palliative Care core curricula recommendations for psychologistsThe Task Force on Education for Psychologists in Palliative Care is an initiative of the EAPC with the goalof developing European guidelines for quality, practice and education of psychologists in palliative care (4).The Task Force aims to gather information about the varying roles, professional identities and education ofpsychologists in European countries; to define essential competencies for psychologists working in fields ofpalliative care (such as direct patient consultation, education, management and research) and to develop acommon curriculum. This is conducted through needs assessment among psychologists themselves, patients,relatives and staff about the desired support by a psychologist and, finally, a consensus process.Similar task forces are in place to develop core competencies and curricula for education and training of otherprofessionals, such as:• nurses (5);• physicians, with a curriculum in palliative care for undergraduate medical education (6) and a postgraduatecurriculum in preparation (7); and• neurologists (8).Sources: personal communications, Sheila Payne, International Observatory on End of Life Care, Lancaster University, United Kingdom andSaskia Jünger, University Clinic Aachen, Germany.References1. Sanders C et al. Development of a peer education programmefor advance end-of-life care planning. International Journal ofPalliative Nursing, 2006, 12:214–223.2. Palliative care courses, MSc, diploma and certificate [web site].London, King’s College London, 2010 (http://www.kcl.ac.uk/schools/medicine/depts/palliative/spc, accessed 1 December2010).3. Koffman J, Higginson IJ. Assessing the effectiveness andacceptability of inter-professional palliative care education.Journal of Palliative Care, 2005, 21:262–269.4. Education for Psychologists in Palliative Care – an EAPC TaskForce [web site]. Milan, European Association forPalliative Care, 2010 (http://www.eapcnet.org/projects/Psychologists.html, accessed 1 December 2010).5. De Vlieger M et al. A guide for the development of palliativenurse education in Europe. Milan, European Associationfor Palliative Care, 2004 (http://www.eapcnet.org/projects/nursingeducation.html, accessed 1 December 2010).6. EAPC Task Force on Medical Education. Curriculum in palliativecare for undergraduate medical education: recommendationsof the European Association for Palliative Care. Milan,European Association for Palliative Care, 2007 (http://www.eapcnet.org/projects/TF-EducForPhys.html, accessed 1 December2010).7. EAPC Task Force on Medical Education. For the developmentof postgraduate curricula leading to certification in palliativemedicine: recommendations of the European Association forPalliative Care. Milan, European Association for Palliative Care,2009 (http://www.eapcnet.org/projects/TF-EducForPhys.html,accessed 1 December 2010).8. The development of guidelines and a core curriculum for thepalliative care for people with neurological disease – an EAPCtask force [web site]. Milan, European Association for PalliativeCare, 2009 (http://www.eapcnet.org/projects/Neurology.html,accessed 1 December 2010).23
Page 1: PALLIATIVE CAREFOR OLDER PEOPLE:BET
Page 4 and 5: AbstractPopulations around the worl
Page 7 and 8: ForewordSocieties in the WHO Europe
Page 9 and 10: AcknowledgementsThe WHO Regional Of
Page 11 and 12: 1IntroductionPalliative care is an
Page 13 and 14: By 2050, estimates indicate that mo
Page 15 and 16: • training of health care profess
Page 17 and 18: individuals and their families. Hea
Page 20: Fig. 3.2. Factors associated with p
Page 23 and 24: (Table 4.1). After 15 years, more t
Page 25 and 26: • the last days of life and death
Page 27 and 28: Box 4.4. Gerontology Institute “1
Page 29 and 30: 5National awareness“You matter be
Page 31: 6Educational interventionsA well-pe
Page 35 and 36: initiated at an early stage in the
Page 37 and 38: 8Improving care for older people in
Page 39 and 40: 9Improving palliative care for olde
Page 41 and 42: Box 9.3. Training in end-of-life ca
Page 43 and 44: 10Improving palliative care for old
Page 45 and 46: References1. Higginson IJ, Sen-Gupt
Page 47 and 48: Financial help, such as the paid co
Page 49 and 50: (Box 12.2). Several drugs can often
Page 51 and 52: 13Advance care planningAdvance care
Page 53 and 54: References1. Advance care planning:
Page 55 and 56: References1. Campbell H et al. Inte
Page 57 and 58: Box 15.1. Bus rounds as an educatio
Page 59 and 60: palliative care research initiative
Page 61 and 62: References1. Currow DC et al. A fra
Page 63 and 64: • Promote public awareness of pal
Page 65 and 66: 3. Invest in creative research into
Page 67 and 68: GermanyEberhard KlaschikCentre for
Page 69 and 70: United Kingdom (continued)Marilyn K
Page 71 and 72: The Maruzza Lefebvre D’Ovidio Fou

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