Photo by Joyce Huis on Unsplash
Sofia Reppou
Research Associate
Aristotle University of Thessaloniki
Palliative Care has a long history in Greece since the era of Hippocrates (c. 460 – c. 370 BC) and Galenus (129 AD – c. 200/c. 216) who distinguished the care of the patient between the pharmaceutical intervention for the body and a more holistic approach for the patient’s quality of life. Paradoxically, the development of palliative care in Greece has been at the lower places of the European Union together with Bulgaria, Estonia and Latvia. There is no comprehensive provision of services to groups of the population particularly at need. There is a lack of systematic recording and evaluation of patients’ needs. Family members hold the role of the basic caregiver as well as private caregivers (mostly immigrants/females).
The Ministry of Health, with the support of the Stavros Niarchos Foundation (SNF), has recently published a report on the status of palliative care in Greece and the immediate actions that should be undertaken. According to this study (Feasibility study on palliative care in Greece, February 2019, Athens), there are currently only three Specialized Palliative Care programs in the country, serving approximately 600 patients per year. There are 57 pain clinics in public hospitals. Pain clinics offer, on top of drug prescription, some forms of general palliative care. There is only one active hospice, the Galilee Hospice (https://www.galilee.gr/en/) and a Specialized Comfort Care (home) program is under development. NGOs and groups of volunteers seem to play a primary role in the services of palliative care available.
This study estimates that there are 120,000 to 135,000 patients and their families that need palliative care services annually. More than 95% of these patients are eligible for palliative care at home if this service existed. An estimated 20% of the Greek population is older adults (65+) trying to survive in a health system that does not properly support severe illness and comorbidities, downgrades the importance of care at home and does not apply adopted policies for home care. Their caregivers are mostly family members finding themselves totally neglected by policies, without an income or health insurance after quitting their job to support their family. In addition, palliative care is still in its infancy and basically an unknown concept for all stakeholders (patients, health professionals and policy makers).
It is of high importance and should be of high priority for Greece to bridge the gap in access to Palliative Care. Existing legislation that impedes the promotion of Palliative Care in the country should be urgently reformed. Training health professionals should also be a priority as, currently, palliative care is roughly absent from the curriculum of medicine and psychology studies. A clear regulatory framework, clinical guidelines, development of a Patient Registry and the development and implementation of operating standards for Palliative Care Units should be immediately set up. The Ministry of Health should work towards allocating all the needed funds. Palliative Care should be available for all adults and children across the country ensuring the quality of life for all patients.
References:
1. Feasibility study on palliative care in Greece, February 2019, Athens (https://www.snf.org/en/newsroom/news/2019/05/presentation-of-study-findings-on-palliative-care-in-greece/)
2. Dimoula, M., Kotronoulas, G., Katsaragakis, S., Christou, M., Sgourou, S., Patiraki, E. (2019). Undergraduate nursing students’ knowledge about palliative care and attitudes towards end-of-life care: A three-cohort, cross-sectional survey. Nurse Education Today, 74:7-14.
3. Tsilika, E., Parpa, E., Galanopoulou, N., Gennimata, V., Mosa, E., Galanos, A., Mystakidou, K. (2016). Attachment orientations of Greek cancer patients in palliative care. A validation study of the Experiences in Close Relationships scale (ECR-M16). J BUON. 2016 Jul-Aug;21(4):1005-1012.