Palliative care, for over 3,000 elderly people focus on care in hospital and in nursing homes
The early introduction of these therapies integrated with responses to the psychological and social needs of patients markedly improves their ability to cope with the disease: hence the geriatricians' survey of facilities and wards across the country
by Dario Leosco *, Graziano Onder **, Monica Torrini ***
There are over 300,000 elderly people in need of relief from suffering caused by complex, progressive and incurable diseases. Despite the fact that the right to palliative care is enshrined in law, there is insufficient coverage, even though the need is destined to grow due to the ageing population and the increase in chronic diseases, with the World Health Organisation estimating access at around 15 per cent.
In order to recognise and measure the needs for palliative care in residences for the elderly and in hospitals, traditionally not organised and sensitised to provide this type of treatment, the Italian Society of Gerontology and Geriatrics (Sigg) will coordinate, together with the main scientific societies, associations and foundations in the field of geriatrics, internal medicine, palliative care and social health care, the first and largest survey on the state of palliative care in hospitals and RSAs.
L’istantanea
The survey, which will take place on the occasion of the National Palliative Care Day on 11 November, will provide a snapshot of the situation in 144 RSAs and 207 hospital wards throughout Italy, involving over 3,000 patients. Numerous scientific evidences have shown that the early introduction, already in the early stages of serious and incurable illnesses, of palliative care, also integrated with responses to the psychological and social needs of patients, is associated with significant improvements in the elderly person's ability to cope with the disease, with a positive impact also on his or her overall wellbeing and that of family members and caregivers.
More efficiency for the NHS
In addition to the clinical and psychological benefits, early adoption of palliative care has been shown to contribute to greater efficiency in the use of healthcare resources, reducing overall treatment costs and the length of hospital stays. In other words, early palliative care not only improves the patient's quality of life but also contributes to a more sustainable and effective healthcare system. Despite the introduction of Law 38/2010 enshrining the right to palliative care in Italy, a significant gap still persists between the needs of patients and the responses provided by the healthcare system. In this context, not only hospices and home-based units, but also residential facilities for the elderly and hospitals, contribute in a complementary way to the management of vulnerable elderly people who need specific, continuous and customised palliative care.
Operators to raise awareness
It is for this reason that the survey is also aimed at raising the awareness of the professionals working in these settings, facilitating the taking care of the needs of patients in these facilities. The survey will be developed through the administration of a short questionnaire filled in by healthcare professionals, doctors and nurses, and will take into consideration indicators and measures useful to assess the palliative care needs of individual patients, such as pain, pressure ulcers, malnutrition, walking ability and delirium. It will be possible to identify patients with palliative care needs at an early stage on the basis of indicators of disease severity and on assessment of loss of autonomy, weight, cognitive decline, unplanned admissions and overall decline of the patient.
