Palliative care for older people: Better practices

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This task force was establised with the support of the Maruzza Lefebvre Foundation,  Rome in September 2007. It has concluded its work with the publication of the booklet in May 2011. 

  • “I am convinced that this publication will be a source of inspiration, awareness and action.”
    Zsuzsanna Jakab, WHO Regional Director for Europe

  • “This publication offers a way forward, with numerous examples of care models at varying stages of integration and implementation.”
    Kathleen M. Foley, Professor of Neurology and Clinical Pharmacology, Weill Medical College of Cornell University, Ithaca, NY, USA


Populations around the world are ageing, and more people are living with the effects of serious chronic illness towards the end of life. Meeting the needs of this vulnerable population is now identified as a challenging and growing public health issue.

This publication, which was supported by funding from the Fondazione Maruzza Lefebvre D’Ovidio Onlus, provides examples of better palliative care practices for older people to help those involved in planning and supporting care-oriented services most appropriately and effectively. It builds on two previous publications in the WHO Solid Facts series, Palliative care – the solid facts and Better palliative care for older people, which set out the growing needs of older people, showed some of the problems faced in the European Region and introduced the concept of palliative care. These two booklets have been widely read and used, have been translated into many European languages and have helped palliative care to develop in many countries. However, they lacked specific detailed examples of how practice may be changed. We have gathered, from the literature and an international call, innovative and creative examples of palliative care for older people, particularly focusing on the European Region. Examples were appraised by an international panel of experts from different disciplines and countries. We included examples of ways to improve palliative care in various settings such as in hospitals, in nursing homes and at home. We also included examples of how symptoms can be improved, family members and caregivers supported and staff educated in the many places in which older people receive care. Since this publication does not have space to cover many other examples, these are listed in a table available at: www.csi.kcl.ac.uk.

Palliative Care for older people: better practices targets policy- and decision-makers within government health and social care, nongovernmental, academic and private sectors and health professionals working with older people. We make recommendations for health policy- and decision-makers, health professionals and those funding research on how services may be developed and improved. These recommendations highlight the need to recognize the palliative care needs of our rapidly growing population of older people and to develop, invest in and implement a palliative care strategy that includes specifically the needs of older people.  They also highlight the need to invest in research programmes to determine the cost-effectiveness of ways to improve palliative care for older people.This task force worked closely with the European Union Geriatric Medicine Society.


What evidence is there about the specific environmental needs of older people who are near the end of life and are cared for in hospices or similar institutions?

Palliative Medicine 2010 24(3): 268-285

Relatively little is known about the type of physical environment which is needed and preferred by patients aged 65 and over, with a prognosis of 1 year or less, who are receiving care in hospitals, care homes and hospices, and their families and staff. A narrative literature review was conducted to identify and analyse evidence on this ssue, with twenty-nine papers meeting the inclusion criteria.

The patients were found to have a wide range of views on their environment, but there was some variation between the views of patients and those of their families and staff. Four main themes emerged:
the physical environment should be ‘homely’; it should support patients’ need for social interaction and privacy; it should support the caring activities of staff, family members and patients; and it should allow opportunities for spiritual expression. It is evident that the physical environment contributes significantly to the quality of life of older people with a life-limiting illness, and there is a need for more research in this area. Regular assessment of patients’ environmental needs should form part of care planning.

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Next Article Aging, pain and palliative care



Sue Hall, UK

Hristina Petkova - UK

Agis Tsouros - Denmark

Massimo Costantini - Italy

ene J Higginson - UK 

Partners and Contributors 

The Maruzza Lefebvre D’Ovidio Foundation provided funding for this publication. In addition to the EAPC, key partners in this taskforce, include: King’s College London; WHO; Cicely Saunders International; and European Union Geriatric Medicine Society.

The following people contributed to the project:

Elizabeth Davies - United Kingdom

John Ellershaw - United Kingdom;

Mariléne Filbet - France

Carl Johan Fürst - Sweden

Giovanni Gambassi - Italy

Stein Kaasa - Norway

Lukas Radbruch - Germany

Florian Strasser - Switzerland

Joan Teno - USA

Vittorio Ventafridda, Honorary President of the European Association of Palliative Care - Italy