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The integration of palliative care in nursing homes


 For a number of years now, establishing a culture of palliative care has become more important in residential care for older people. While nursing homes are recognized as significant places for end-of-life care, research shows there is quite a lot of variation in the quality of end-of-life care among nursing homes. One of the problems leading to this variation is the lack of collaboration between the different organizations and their professionals. A better integrated palliative care could be realized by optimized collaboration between nursing homes, home care and hospital care in Flanders.


The aim of the present study is threefold:
1. to analyse the collaboration between nursing homes, home care services and hospitals within Flemish palliative care, at organizational level, in a baseline assessment;
2. to model an intervention in order to improve the implementation of the principles of collaboration and integrated care at an organizational level (meso-level), within the Flemish palliative networks;
3. to pilot, evaluate and adjust the intervention 


The model developed by D’Amour and colleagues (2008) states that the process of collaboration between care professionals and their organizations can be analysed in terms of four dimensions and 10 indicators. The present collaboration between nursing homes and home care services on the one hand and nursing homes and hospitals on the other hand will be mapped by means of a validated audit instrument assessing the indicators of the model of D’Amour. Coordinators and key figures of the 15 palliative networks in Flanders are questioned. The quantitative data of this baseline-assessment will be presented to expert panels of important stakeholders within the 15 palliative networks in order to explore the results in depth. Based on these results and a systematic literature review, an intervention will be developed in order to optimise the collaboration of palliative care services (MRC framework phase 0, 1 and 2). 


The study will result in an audit instrument adapted to the context of integrated palliative care, a feasible and effective intervention for large-scale implementation, policy and practice recommendations as well as scientific publications in national and international journals.

Project group

Sofie Hermans: researcher
Dr. Aline Sevenants: supervisor
Dr. Nele Spruytte: member
Prof. dr. Anja Declercq: co-promoter
Prof. dr. Joachim Cohen: co-promoter
Prof. dr. Luc Deliens: promoter
Prof. dr. Chantal Van Audenhove: promoter