title: A qualitative exploration of the collaborative working between palliative care and geriatric medicine: Barriers and facilitators from a European perspective.
abstract: BACKGROUND
  With an increasing number of people dying in old age, collaboration between palliative care and geriatric medicine is increasingly being advocated in order to promote better health and health care for the increasing number of older people. The aim of this study is to identify barriers and facilitators and good practice examples of collaboration and integration between palliative care and geriatric medicine from a European perspective.
  
  
  METHODS
  Four semi-structured group interviews were undertaken with 32 participants from 18 countries worldwide. Participants were both clinicians (geriatricians, GPs, palliative care specialists) and academic researchers. The interviews were transcribed and independent analyses performed by two researchers who then reached consensus.
  
  
  RESULTS
  Limited knowledge and understanding of what the other discipline offers, a lack of common practice and a lack of communication between disciplines and settings were considered as barriers for collaboration between palliative care and geriatric medicine. Multidisciplinary team working, integration, strong leadership and recognition of both disciplines as specialties were considered as facilitators of collaborative working. Whilst there are instances of close clinical working between disciplines, examples of strategic collaboration in education and policy were more limited.
  
  
  CONCLUSIONS
  Improving knowledge about its principles and acquainting basic palliative care skills appears mandatory for geriatricians and other health care professionals. In addition, establishing more academic chairs is seen as a priority in order to develop more education and development at the intersection of palliative care and geriatric medicine.
authors.affiliation: Federation Palliative Care of Flanders (FPCF), Vilvoorde, Belgium. gwenda.albers@gmail.com.|Department of Medicine, Division of Geriatrics and Gerontology, Ghent University Hospital, Ghent, Belgium. gwenda.albers@gmail.com.
authors.forename: Gwenda
authors.initials: G
authors.lastname: Albers
authors.affiliation: International Observatory on End of Life Care, Lancaster University, Lancaster, UK.
authors.forename: K
authors.initials: K
authors.lastname: Froggatt
authors.affiliation: End-of-life Care Research Group, Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium.
authors.forename: L
authors.initials: L
authors.lastname: Van den Block
authors.affiliation: Istituto di Medicina Interna e Geriatria, Università Cattolica Sacro Cuore, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Gambassi
authors.affiliation: Department of Medicine, Division of Geriatrics and Gerontology, Ghent University Hospital, Ghent, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Vanden Berghe
authors.affiliation: Division of Primary Care, University Hospitals Geneva, University of Geneva, Geneva, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Pautex
authors.affiliation: Federation Palliative Care of Flanders (FPCF), Vilvoorde, Belgium.
authors.forename: N
authors.initials: N
authors.lastname: Van Den Noortgate
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D005060:Europe / Q000453:epidemiology; D005260:Female; D005853:Geriatrics; D006301:Health Services Needs and Demand; D006299:Health Services for the Aged / Q000458:organization & administration / Q000592:standards; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000458:organization & administration / Q000592:standards; D017410:Practice Guidelines as Topic; D036301:Qualitative Research