Palliative Care for Older People in Care and Nursing homes in Europe – The EU FP7 funded PACE project
PACE is a major European Union funded research project that focuses on the care of older people in long stay care facilities in six countries throughout Europe: Belgium, Finland, Italy, the Netherlands, Poland, and the United Kingdom.
The PACE consortium consists of 8 research institutes, spanning 6 European countries, and 4 European organizations responsible for impact and dissemination: the European Association for Palliative Care, Alzheimer Europe, Age Platform Europe, and the European Forum for Primary Care.
The proportion of the world’s population aged over 60 is expected to rise considerably. This will lead to more people dying in late old age with generalized frailty or neurological failure, follo
wing a slow dying course with multiple chronic diseases and complex palliative care needs. These developments have enormous clinical, societal and socio-economic implications common to all EU countries.
Whilst many countries aim to enable people to live in their own homes, many older people will require long term institutional care at the end of life. Also, a significant proportion eventually dies in care or nursing homes. Despite these well-known facts, palliative care has only recently been introduced in such facilities.
Following the European 2020 Strategy, the PACE project (2014-2019) will develop specific tools and products to assist policy and decision-makers at national and European levels in making evidence-based decisions on optimal palliative care delivery in long stay care facilities.
- Map palliative care structures and policies in care and nursing homes across Europe
- Describe and compare the quality of care at the end of life and the quality of dying in six EU countries, and explore the structural characteristics related to better outcomes
- Evaluate the effect of the innovative ‘PACE Steps to Success’ palliative care intervention in care and nursing homes on quality of care, quality of dying and staff competences
The PACE project consists of three studies. First of all, in PACE we mapped palliative care systems in care or nursing homes in Europe. Secondly, the consortium performed a large-scale representative study to examine quality of dying and palliative care in care or nursing homes in Europe. In this study, 322 facilities participated across the 6 countries and we were able to collect data about the end of life of 1707 residents. Last, PACE will study the impact of an innovative intervention ‘PACE Steps to Success’ in a cluster randomized controlled trial. The ‘PACE Steps to Success’ intervention has been adapted from the ‘Route to Success’ programme which was developed by the End-of-Life Care Programme in the United Kingdom. The programme aims to help staff caring for frail older people in care or nursing homes to deliver high quality palliative and end of life care. It aims to integrate palliative care into daily practice so that it becomes embedded within the delivery of care and helps to create sustainable and realistic change within care and nursing homes across Europe. 160 facilities participated in the trial in 7 countries (the 6 PACE countries and also Switzerland). Results of the trial will be available later this year.
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