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End-of-life care

2017: Standards for Residential Care Facilities

General Overview

No provisions regarding palliative care at the end of life for older people living in residential care facilities were found in Bulgaria, Cyprus, Hungary, Italy, Latvia, Poland, Portugal, Slovakia and Turkey[59].

In Finland, Germany, Netherlands, Sweden and the UK (England) guidelines about care at the end of life exist, but the recommendations in these documents are not binding in nature. In Finland, the care guidelines specifically recommend the avoidance of unnecessary transfers to hospital in the final stages of dementia. In 2017, the Government of Croatia has approved the National Program for the development of Palliative Care in the Republic of Croatia (2017–2020). This plan addresses issues related to palliative care in primary care and in care homes for the older people. In the plan, people with dementia are recognised as a vulnerable group with special needs.

Specific reference to the provision of end-of-life care in residential care facilities can be found in the legislation or National Standards in Belgium (Flanders and Wallonia), France, Ireland, Lithuania, Luxembourg, Malta, Romania, Switzerland60 and the UK (Northern Ireland, Wales, Scotland).

  • In addition to the provision of care, comfort and pain relief, in Ireland, Lithuania, Malta and the UK (Northern Ireland and Wales) there is a reference to the need to respect the values and preferences of the resident when providing care at the end of life and treat the person with dignity and respect. In Ireland every effort should be made to ensure that the resident’s choice as to the place of death, including the option of a single room or returning home, is identified and respected as far as practicable.
  • —In Finland, France, Ireland, Lithuania, Malta, Netherlands, Romania, Switzerland and the UK, the requirements state that the religious and spiritual needs and practices of the resident should be met.
  • —In France and Luxembourg, residential care facilities should develop a project or plan including their approach to end-of-life care. In France, this plan needs to be developed jointly by the director of the centre and the medical doctor and it should also include the planned collaboration with specialist palliative care teams in the area.
  • —In Belgium (Flanders) the medical doctor and the head nurse should promote a culture of palliative care and raise awareness among staff. In Belgium (Wallonia), a federal law guarantees the provision of end-of-life care to all patients. However, further details about how the care is implemented are provided in regional legislation.


59  In some cases, a legal framework for palliative care exists but not in the context of residential care facilities. For example, in Portugal, the existing legal framework applies to palliative care provided in primary care, hospital settings and integrated continuous care units. In other cases, policies may exist but for people with other conditions e.g. cancer.

60  At cantonal level.






Last Updated: Friday 31 January 2020


  • Acknowledgements

    This Dementia in Europe Yearbook received funding under an operating grant from the European Union’s Health Programme (2014-2020). The content of the Yearbook represents the views of the author only and is his/her sole responsibility; it cannot be considered to reflect the views of the European Commission and/or the Consumers, Health, Agriculture and Food Executive Agency or any other body of the European Union. The European Commission and the Agency do not accept any responsibility for use that may be made of the information it contains.
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