ENVI

Committee on Environment, Public health and Food safety - ENVI

According to The 2015 Aging Report, it is expected that the proportion of people aged 80 and over in the EU will rise from 5% to 12% of the population in 2060. With 2.5 million European citizens dying due to terminal diseases every year, which steps can the EU take to secure comprehensive and accessible palliative care?

Sára Zelenko (CZ)

What?

Due to the expected rise in the elderly proportion in the European communities, there will only be two working-age people for each person aged over 65 by 2060. This means that many people in retirement age will be left without support or without someone to take care of them in their time of need. In addition, the older population makes up a sizable portion of the 2.5 million Europeans suffering from a terminal disease each year.

Palliative care is the last phase of health and social care for citizens before their death in the context of advanced disease and end-of-life care in the final months/weeks of life. In the Czech Republic, there is not enough representative data that could accurately depict the national palliative care systems. However, based on overall coverage and the organisations advocating for palliative care in the Czech Republic, the options are very limited. Many doctors refuse to visit their patients at home and only prescribe them sufficient medication to relieve their pain. In nursing homes the quality differs, but usually the situation is similar to those staying at home.

Links for your further research:

Palliative care explained by WHO

Specification on diseases treated by palliative care

Why?

In Czech Republic, roughly sixty to seventy thousand people die due to terminal diseases such as cancer or cardiovascular diseases and in all of the EU the number reaches 2.5 million. Elderly people are at the greatest risk of contracting these diseases and thus suffer the most when proper palliative care needs are not met. According to the WHO resolution on palliative care, only 14% of those in need of palliative care receive it even though early delivery of palliative care reduces unnecessary hospital admissions and thus the burden on hospital staff and budget. In addition, according to a case study conducted by WHO, only 12 EU countries possess a palliative care plan, the Czech Republic not being one of them.

While many doctors do not receive enough education in this field, others do not have the opportunity or the motivation to be palliative care providers, since other medical practices seem more appealing.

Families often have to decide if they need to send their loved ones to hospital. In many cases, home environment is not enough to take care of the patients. However, at the hospital, the family has worse options of staying with their relatives and the psychological needs of the patients are not met sufficiently. Communication between the family and the doctor is of course required as well and is another problem, since one sick person may be in need of many different specialists to receive the best care, but the patients’ medical information is not always shared efficiently.

Many doctors and patients alike do not really know what to expect from the development of this field, but overall, we should strive for better quality and the wellbeing of the ill.

Links for you to check out about this:

Qualitative systematic review of palliative care

Analysis on the development and integration of PC across Europe

Who?

Each year globally around 40 million people are in need of palliative care and 78% of them live in low or middle-income countries. As the average age of population grows, so does this number, as older people are the ones most at risk of terminal diseases.

The greatest possibility of change lies with the Member States’ governments, mainly the Ministries of Health, with the help of EU funding. The EU does not have the authority to issue official laws in this case, but they have the option of coordinating and inspiring the Member States to take action with their supporting competences.

Some organizations are linked to the EU work in the field of palliative care, a great example is the European Association for Palliative Care (EAPC), which is recognized by the Council of Europe. They work together with EU-policy makers to shape EU policies on palliative care issues.

InSup-C, which was a project undertaken between 2012 and 2016 that focused on integration of palliative care and creating specific guidelines for different illnesses. The project consisted of six EU countries and conducted research on identifying best palliative care practices.


If you’d like to know more, check these sources:

Different palliative care guidelines in Europe

Palliative care in Europe

How?

More widespread education is provided in the field of palliative care by different EU or national organisations such as EAPC and EAPC Research Network Junior Forum, which provide a way of educating both children and adults about the topic.


A project focused on Czech Republic is the Avast Foundation project Together until the end. This project focuses on hospices through financial support and introduction of palliative care as a subject to selected universities. Thanks to the success of the initiative, the Czech government has decided to provide additional funding for palliative care.

Ireland not only has national guidelines for palliative care, but also specifies a policy on palliative care for children with life-limiting conditions. This policy provides a framework for supporting families and health care professionals so they are available for the children at their own homes.

Switzerland also has a system, which is largely inspired by already existing models from abroad, mainly Canada, USA, England and Australia and it also refers to the guidelines of EAPC. Canada provides free palliative care in homes, hospices and hospitals, which includes not only providing professionals, but also psychological and spiritual support for the patient and the family alike.


Many people suffer from terminal conditions and are in need of financial and psychological support. The illness is difficult not only for them but for their whole family as well. The improvement of palliative care should involve dealing with all of the problems mentioned above, but also try to provide enough resources for the families to work with and to create the possibility of the patient to stay at home with their family without causing them extreme financial and psychological burdens connected to caring for someone with a terminal disease. It is important for them to receive support not only from the community, but also from the people not directly involved in palliative care.


The overly restrictive regulations on essential medicine make it extremely difficult for families to obtain pain relievers, such as morphine, for their sick family members.

It is important to secure the availability of palliative care to all people irrespective of their income, disease type, age or race.


Even more information on this topic:

Website that guides you to palliative care near you (only US palliative care programs)

Podcasts about palliative care programs



ENVI Topic Video.mp4

Topic video