title: Quality palliative care for cancer and dementia in five European countries: some common challenges.
abstract: OBJECTIVE
  There is a growing consensus worldwide that palliative care needs to be both more inclusive of conditions other than cancer and to improve. This paper explores some common challenges currently faced by professionals providing palliative care for patients with either cancer or dementia across five countries.
  
  
  METHODS
  One focus group (n=7) and 67 interviews were conducted in 2012 across five countries: England, Germany, Italy, the Netherlands and Norway, with professionals from dementia, cancer and palliative care settings.
  
  
  RESULTS
  The interviews revealed five common challenges faced across the five countries: communication difficulties (between services; and between professionals, and patients and their families); the variable extent of structural/functional integration of services; the difficulties in funding of palliative care services; problematic processes of care (boundaries, definitions, knowledge, skills and inclusiveness) and, finally, time constraints.
  
  
  CONCLUSIONS
  These are not problems distinct to palliative care, but they may have different origins and explanations compared to other areas of health care. This paper explored deeper themes hidden behind a discourse about barriers and facilitators to improving care.
authors.affiliation: a Research Department of Primary Care and Population Health , University College London , London , UK.
authors.forename: Nathan
authors.initials: N
authors.lastname: Davies
authors.forename: Laura
authors.initials: L
authors.lastname: Maio
authors.forename: Jasper
authors.initials: J
authors.lastname: van Riet Paap
authors.forename: Elena
authors.initials: E
authors.lastname: Mariani
authors.forename: Birgit
authors.initials: B
authors.lastname: Jaspers
authors.forename: Ragni
authors.initials: R
authors.lastname: Sommerbakk
authors.forename: Daniela
authors.initials: D
authors.lastname: Grammatico
authors.forename: Jill
authors.initials: J
authors.lastname: Manthorpe
authors.forename: Sam
authors.initials: S
authors.lastname: Ahmedzai
authors.forename: Myrra
authors.initials: M
authors.lastname: Vernooij-Dassen
authors.forename: Steve
authors.initials: S
authors.lastname: Iliffe
mesh_terms: D000328:Adult; D019033:Delivery of Health Care, Integrated / Q000191:economics / Q000592:standards; D003704:Dementia / Q000451:nursing*; D004739:England; D005260:Female; D005858:Germany; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007400:Interprofessional Relations; D007558:Italy; D008297:Male; D009369:Neoplasms / Q000451:nursing*; D009426:Netherlands; D009664:Norway; D010166:Palliative Care / Q000191:economics / Q000592:standards*; D011368:Professional-Family Relations; D011369:Professional-Patient Relations; D036301:Qualitative Research; D011787:Quality of Health Care / Q000191:economics / Q000592:standards*; D013997:Time Factors