Filenews 17 June 2025 - by Marilena Panagi
The basic principle is the fact that "each person is unique, their experiences are different, each patient case is unique and therefore its management must be individualized". Doctors, nurses, psychologists, social workers, other health professionals, and even religious representatives (depending on religion) if the patient so wishes, will make up the multidisciplinary team that will provide palliative care and support both to the person suffering from a life-threatening or complex and complex disease, as well as to his family.
The team, which will consist of at least five members, will offer its services to the patient and their family from the first moment of diagnosis, while in cases where the end occurs, the team will also be responsible for supporting family members in managing bereavement.
The bill for the operation of structures/institutions for the provision of palliative care has been submitted to the Parliament and its passage into law will pave the way for the support and support of patients, both at the level of inpatient or institutional care, as well as at the level of home provision of services. With its adoption and implementation, after all, a huge gap in the health sector in Cyprus will be filled, since until now palliative care services are offered fragmentarily through the GHS, due to the lack of a regulatory framework, only to cancer patients.
According to the bill, these services will be provided through six different structures/bodies.
"The provision of palliative care aims to improve the quality of life of patients and their families who face problems related to life-threatening diseases or complex and complex health problems, through the prevention and alleviation of suffering, thanks to the early detection and appropriate assessment and treatment of pain and other physical problems; psychosocial, mental problems and needs by a specialized multidisciplinary team", the preamble of the bill states and clarifies that "palliative care is not only addressed to patients with predetermined diagnoses".
The World Health Organization, as reported, defines palliative care as the service which "confirms life and considers death as a normal process" and "does not intend to hasten or postpone death" but aims to "improve the quality of life and, where possible, positively influence (where possible) the course of the disease".
Palliative care in six different ways
A. Inpatient Palliative Care Unit: These are units that will operate in hospitals, will have at least six beds and will provide specialized palliative care through a multidisciplinary team.
B. Palliative Care Center: They will be autonomous health units, which will provide the relevant services.
C. Mobile Inpatient Palliative Care Team: Teams that will consist of medical and nursing staff (or other professionals on a case-by-case basis), specialized. She will visit staff and patients in various hospital units that do not specialize in palliative care and provide guidance and support for the provision of palliative care.
D. Day Care Unit: They will be units that will provide specialized palliative care by an interdisciplinary team.
E. Palliative Care Shelter: These are units that will have at least eight beds and will provide palliative care by an interdisciplinary team.
F. Home Palliative Care Service: These are home services that will be offered by an interdisciplinary team that will also provide the appropriate equipment for each patient's case.
Cooperation with the patient and his family
Palliative care services will always be offered in cooperation with the patient himself but also with his family members and caregivers.
As stated in the relevant bill, "the patient, his family and his caregivers will work with the interdisciplinary team to discuss and plan the patient's palliative care", while "the members of the interdisciplinary team will use international guidelines for the provision of palliative care that include both pharmaceutical and non-pharmaceutical interventions".
Different management of adults, children and end-stage patients
The management of adult patients, children and end-stage patients will be done in a different way in order to meet the individual needs of the person receiving the palliative care.
For children: Members of the multidisciplinary team will provide information tailored to each child's developmental stage and encourage them to actively participate in planning and decision-making regarding palliative care. Further, "the members of the interdisciplinary team will encourage the child to assess and report the pain and other symptoms they are experiencing, while also taking into account the reports of their family and caregivers." Finally, "the provision of psychological support must be adapted to the age and developmental stage of the child".
For adults: "Palliative care will aim to allow the patient to live as best as possible until the end of his life, by actively and immediately preventing and minimizing his symptoms organically, socially, psychologically, spiritually."
For end-stage patients: Palliative care will aim "to allow the patient to live as best as possible until the end of his life by actively and immediately preventing and minimizing his symptoms organically, socially, psychologically, spiritually. The multidisciplinary team will effectively assess and manage the patient's symptoms at the end of their life, so that the patient has a dignified death in accordance with their values and priorities."
When death occurs, "the multidisciplinary team must provide support to the family and caregivers of the patient who received palliative care services regarding loss and bereavement. Recognizing the fact that the course and consequences of bereavement differ for each individual, the team must identify early family members who due to personal and social circumstances are at risk of experiencing problems during preparation and after the patient's death."
Licensing, control, inspections and licensing
The bill also provides for the licensing of structures/bodies providing palliative care services, as well as for the conditions that these spaces must meet. It also provides for the appointment of the Superintendent of Palliative Care Centers and the establishment of a Technical Issues Committee.
Among other things, provision is made for the exercise of control by authorized inspectors and the reasons that may lead to the cancellation or suspension of an operating license.
For the proper provision of palliative care services and the assurance of the quality of these services, a National Council for Palliative Care will be established and operated.
