Mapping palliative care systems in long term care facilities in Europe

Mapping palliative care systems in long term care facilities in Europe

The PACE Work Package 1 Mapping palliative care systems in long term care facilities in Europe is being undertaken in partnership with the EAPC and is  one of their Taskforces.


The aim of this study is to map and classify different structures, organizational models, and policies related to palliative care provision in long term care facilities in Europe.

The definition used to refer to long term care facilities (LTCFs) in this study is of a setting where care is provided for older people, who live there, 24 hours a day, 7 days a week. The care provided includes on-site provision of personal assistance with activities of daily living.  Nursing and medical care may be provided on-site or provided by nursing and medical professionals from services external to the setting.


The mapping study is being undertaken in 29 European countries:  Albania, Austria, Belgium, Croatia-Hrvatska, Cyprus, Czech Republic, Denmark, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Israel, Italy, Latvia, Lithuania, Luxembourg, The Netherlands, Norway, Poland, Portugal, Romania, Spain, Sweden, Switzerland, Turkey and the UK.

Data is being collected in two ways:

i)       country mapping survey

Working with country informants the following data is sought about each country: organisation of care; place of death; types of LTCFs and terminology; resident populations in LTCFs; status of LTC provision; funding of LTCF provision; regulation of LTCFs; and key drivers for change in LTCFs at national and regional levels.

ii)     documentary review

Policy documents, research studies and reports are examined to supplement the data provided in the mapping surveys. This has allowed data on the broader context of LTCFs to be described, against which specific data about palliative care provision in LTCFs can be contextualised. 


Three types of LTCFs have been identified across Europe, based on how nursing and medical care is provided either by the LTCF staff or from external services.


On-site: physicians, nurses, care assistants


On-site: nurses, care assistants

Off-site: physicians


On-site:  care assistants

Off site: physicians, nurses





The final report on this study presents an account of the LTCF context reporting on:

  • Country demographics

  • LTCF availability

  • LTCF organisational status

  • Types of LTCFs

  • LTCFs as a place of death


Approaches to the development of palliative care provision in LTCFs are being considered with reference to the classification of palliative care development in countries as mapped in the EAPC Atlas of Palliative Care in Europe. A typology of palliative care development in countries is being constructed based on evidence of policy level engagement and the nature and spread of implementation activities.

The report is being finalised and will be made available later in 2016. 

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