Anyone suffering from an incurable illness and only has a limited time left to live can avail of palliative care.
Palliative care* is about offering patients physical, psychological, social and spiritual support. It does not delay or accelerate a person's death but it does help maintain the quality of life of the incurably ill person. This is achieved by means of pain and symptom management, by offering psychological support to the patient and his immediate family, or by focusing on the meaning of things and spirituality.
The Service for palliative care and follow-up care is an ambulatory service aimed at the development and improvement of palliative care and follow-up care. The services for palliative care and follow-up care comprise interdisciplinary aid and assistance provided at home or outside the hospital environment to better respond to the physical, psychological and moral needs of patients who are terminally ill as well as of their environment. Palliative care may be provided in hospitals, in homes for the elderly* (HFEs), in rest and nursing homes* (RNHs) and at home.
Palliative care in hospitals
Hospitals operate two different types of palliative care services:
1. The specialist palliative care unit
About half of all general hospitals in Belgium (some 50) have a palliative unit*. This is a small in-house unit that looks after people who are suffering from an incurable illness and will die relatively soon. Here, patients, who can no longer stay in an acute hospital or cannot be looked after at home any more, are offered individual total care by a multidisciplinary team.
2. The mobile palliative care unit
A mobile team can be called upon for patients who are not staying in a palliative unit. This team does not take on the palliative care itself but advises the teams of the department the palliative patient has been admitted to on the palliative care that needs to be provided. It is also tasked with continuous training and awareness-raising about palliative care amongst hospital staff. All Belgian general hospitals and a number of isolated G (geriatric) and Sp (chronic illnesses) departments* have a mobile palliative care team*.
Palliative care in homes for the elderly (HFEs) or rest and nursing homes (RNHs)
All RNHs* and some HFEs* are obliged to offer palliative care. In quite a number of RNHs, at least one member of staff actively deals with palliative care support on a part-time basis.
Palliative care in the home environment
Palliative home care allows patients to die in their own familiar environment.
In Belgium, various measures have been introduced to support the provision of palliative care:
- financial: abolition of the non-refundable part of certain home visits and the fixed palliative care fee
- support for carers: the option of taking palliative leave
- specialist care facilities: palliative day centres and multidisciplinary teams to support carers providing home care.
The palliative care association of the German-speaking Community addresses patients with terminal illnesses in late stages who have a shortened life expectancy and whose diseases are not responsive to curative treatment.
The aim is to provide the best possible quality of life to the patients during the time left to live, through prevention, control and relief of pain and symptoms, but also through communication and by addressing the concerns and needs of the patients and of their social environment.
* see Glossary