Table 2 Classification of in-house and external palliative care services available in nursing homes in six countries
Belgium | Netherlands | England | Finland | Italy | Poland |
|---|---|---|---|---|---|
In-house palliative care service in a nursing home | |||||
NH staff (nurse/care assistants) trained in palliative care Palliative care support team per facility, consisting of: - Coordinating advisory physician (a GP who is responsible for nunrsing home medical management incl. palliative care; however, s/he does not function as a GP of the residents (they have their own GP) -Palliative care reference nurse (to support GPs and nurses operating in the nursing homes) | Type 1: Elderly care physician (also provides general palliative care) and nurse/care assistants trained in palliative care Type 2: Nurse/care assistants trained in palliative care | NH staff (nurse/care assistants) trained in palliative care Palliative care team (specialist nurse and palliative medicine doctor, sometimes other professionals) advise and assess residents, no hands-on care. Some palliative care nurses are linked to the nursing home | Elderly care physicians and registered and licensed practical nurses trained in palliative care | General practitioner and NH staff (nurse/care assistants) trained in palliative care | Type 1: General practitioner and NH staff (nurse/care assistants) trained in palliative care Type 2: no internal palliative care service Difference in availability specialist palliative care advice between type 1 and 2 because of financial contracting law regulation Type 1 is obliged to provide palliative care in the frame of internal service (call on palliative care specialist is an exception). Type 2 calls on external palliative care specialists |
External palliative care service in a nursing home | |||||
External palliative home care team (provides advice or training to nursing home staff) External general physician | Type 1: Access to consultant or consultation team palliative care Type 2: External elderly care physician (also provides general palliative care) Access to consultant or consultation team palliative care | External physicians linked to the nursing home District nurses (deliver hands-on care to older people and provide general palliative care) sometimes linked to the nursing home External specialist palliative care team and care home liaison specialist palliative care nurse | External general physician External elderly care physician or external palliative care team | Palliative care services of the health care district in isolated cases Palliative care services from collaborating not-for-profit organizations | Type 1: no use of external palliative care service Type 2: Hospice team (palliative care specialist physician and palliative care specialist nurse) visiting a resident at residential home |