In 2014 the World Health Assembly Resolution 67.19 called for global strengthening of quality, accessible palliative care service for people of all ages. The resolution mandated for palliative care as an essential health service as part of Universal Health Coverage. This presentation will consider where we are 10 years on from that groundbreaking resolution. How far have we come and what are the priorities to meet the rising demand for palliative care associated with increasing longevity and rising numbers of people living and dying with serious health-related suffering.
Professor Catherine Evans is a senior clinical academic in palliative care and nursing. She is a Professor of Palliative Care and Ageing at the Cicely Saunders Institute of Palliative Care, Policy, and Rehabilitation, King's College London, and Honorary Nurse Consultant, Sussex Community NHS Foundation Trust. She is the Director of the Cicely Saunders Institute. Catherine leads a research programme on integration of palliative care in community and primary care for adults with multiple conditions, including dementia and frailty. Her interventions incorporate new models of integrated community palliative care, use of person-centred outcome measures for holistic assessment linked with clinical decision aids, and digital healthcare for remote assessment and management of care. She leads the EMPOWER Dementia Network+ – empowering a meaningful life for all, and co-leads the programme EMBED-Care Empowering Better End of Life Dementia Care. She is passionate about building research capacity in nursing and professions allied to healthcare, pursuing this in her role as a deputy-director of the King's Clinical Academic Training Office.
Dementia is the 7th leading cause of death worldwide. The number of people with dementia expected to die with serious health-related suffering is projected to increase four-fold to close to 6 million by 2060. Those living with dementia and multimorbidity, are affected by high levels of symptoms and concerns but have poor access to palliative care resulting in distress for both them and their family. A palliative care approach is needed to ensure that all those with dementia receive palliative care at the time that they need it, not just at end of life or in crises.
This presentation details a programme of work utilising a person-centred outcome measure called the Integrated Palliative care Outcome Scale for Dementia (IPOS-Dem) to improve access to palliative care for those living with dementia. The presentation provides an overview of the IPOS-Dem and its development, and its evaluation in care provision. A new co-designed intervention, called the Empowering Better End of Life Dementia Care (EMBED-Care) Framework comprising IPOS-Dem linked to decision-support tools is detailed; with findings from a feasibility study evaluating how the EMBED-Care Framework may improve care and outcomes for people with dementia living at home and in long-term care facilities.
Clare is a Senior Lecturer in Palliative Care at Cicely Saunders Institute, King's College London. As an occupational therapist, Clare has a background of working in older people mental health and dementia services. Her research interests include improving access to palliative care for people living with dementia and multimorbidity, person-centred outcome measurement, and developing and evaluating complex interventions.
Cancer is a major cause of illness burden and is associated with loss of function, disability and death. The incidence of being diagnosed with all cancers (excluding non-malignant skin cancer) has increased in most countries across all age groups older than 50 years. By 2050, it is estimated that 20.5% of all new cancer cases will be in adults over 80. Older people may also be contending with multiple long-term conditions and the effects of ageing. With advances in life extending oncology treatments, people are living longer with their illness and experience more disability. This reduces quality of life and is rated as a common unmet need. In addition, disability in daily activities is closely related to unplanned admissions to hospital.
Rehabilitation is a process that aims to support people to maintain optimal levels of functioning in the physical, emotional, psychological and social domains of their well-being. Integrating rehabilitation in palliative care provides people and their families with strategies they need to maintain independence and self-determination. It equips them to adapt during unpredictable and uncertain periods of change associated with their illness, including when functional decline is inevitable towards the end of life.
The Inspire project aims to deliver a clinically and cost-effective palliative rehabilitation intervention for individuals with incurable cancer that integrates with oncology, palliative care and rehabilitation services. This presentation details the rationale, development and testing of the Inspire intervention in a multi-national randomised controlled trial which is actively recruiting at sites across six European Countries.
Joanne is a Research Fellow at Cicely Saunders Institute, King's College London. As a physiotherapist, Jo has a clinical background working in specialist palliative care services. Her research interests include developing and evaluating complex interventions relating to rehabilitation, multi-professional teams and assistive devices in palliative care.
Many older adults prefer to age and die in their own place of residence, where they feel familiar and comfortable. Increasingly, literature considers the place of ageing and dying as a key indicator of quality of care. However, “place” extends beyond mere location; it may not support ageing and dying without the provision of high-quality place-based care. This presentation introduces the Place-based Model of Rehabilitation, illustrating how a multidisciplinary team can deliver place-based care through a rehabilitation approach, thereby supporting older adults in their journey from ageing to dying in place. It also covers the opportunities and challenges associated with implementing place-based care, along with important considerations for successful implementation.
Linda is a Professor at the School of Nursing and Health Sciences, Hong Kong Metropolitan University. She is an Advanced Practice Nurse and a seasoned nurse educator. She actively engages in research on gerontological and palliative care. Her recent work addresses the challenging issues surrounding ageing in place and its expansion to include dying in place.
