Providing palliative care - A delicate balance between formal and informal care

Palliative care is an approach that attempts to improve the quality of life of patients with a progressive, life threatening illness and their family. It is a total care that focuses not only on the physical, but also the emotional, social and spiritual dimension of a person. Palliative care in Belgium has moved beyond its pioneering years and the literature emphasizes the importance of professionalization: practice should be evidence based instead of based on authority or limited interpersonal consensus, clinical care pathways are being developed for palliative patients, expertise is formulated in terms of competency profiles, palliative care is evaluated using objective criteria etc. On the other hand, however, there is the demographic fact that the population all over Europe is ageing: More and more people will need care while it is already obvious that society can’t afford mere professional help for all these people. Consequently, informal care provided by non-professionals such as volunteers will become more and more important in the future. Non-professional care providers already play an important role in the different palliative care settings.

This raises some interesting questions that are relevant, not only for palliative care, but for health care in general: Are informal care providers necessary only for economic-financial reasons are do they have an added value compared to the care provided by health care professionals? What are important criteria in the selection of volunteers? What are central points of interest for an organization that relies on both volunteers and professionals? What is needed for a fruitful cooperation between these two types of care providers and what are the pitfalls? This speech will illustrate how these issues have been tackled within our Palliative Care Network.

There are also some educational implications worthy of debate: What role can universities and other institutes for higher education play in this? What are the skills and attitudes a professional needs in order to be able to work with volunteers both in patient care and interdisciplinary meetings? Do the present health care curricula take into account these challenges or are there important flaws?

Alexander Verstaen Palliatieve Zorg Noord West Vlaanderen, Belgium

Alexander Verstaen is a doctor of psychology, psychotherapist and director of the Palliative Care Network North-West-Flanders (Belgium). He is a Board Member and lecturer of the School for Comparative Philosophy in Antwerp (Belgium) and teaches as a visiting professor in several psychotherapy training programs. Recently, he founded “Perennis”, a centre for spiritual care, development and therapy. The first initiative of this centre is the 2-year training program “spiritual care for patients with a life threatening illness” which started in september 2010.

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