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Background:People with dementia may benefit from palliative care which specifically addresses the needs of patients and families affected by this life-limiting disease. On behalf of the European Association for Palliative Care (EAPC), we recently performed a Delphi study to define domains for palliative care in dementia and to provide recommendations for optimal care. An international panel of experts in palliative care, dementia care or both, achieved consensus on almost all domains and recommendations, but the domain concerning the applicability of palliative care to dementia required revision.Methods:To examine in detail, the opinions of the international panel of 64 experts around the applicability of palliative care, we explored feedback they provided in the Delphi process. To examine which experts found it less important or less applicable, ordinal regression analyses related characteristics of the panelists to ratings of overall importance of the applicability domain, and to agreement with the domain's four recommendations.Results:Some experts expressed concerns about bringing up end-of-life issues prematurely and about relabeling dementia care as palliative care. Multivariable analyses with the two outcomes of importance and agreement with applicability indicated that younger or less experienced experts and those whose expertise was predominantly in dementia care found palliative care in dementia less important and less applicable.Conclusions:Benefits of palliative care in dementia are acknowledged by experts worldwide, but there is some controversy around its early introduction. Further studies should weigh concerns expressed around care receiving a “palliative” label versus the benefits of applying palliative care early.

Introduction A recent national survey of carers found that only half of family carers providing end of life care received the support they needed and this support was less likely to be provided in hospital.1 Similarly, a study of discharge in older adults found that most family caregivers are not involved in discharge decisions.2 Aims This study aims to understand and support family in the work they do to facilitate end of life discharge. The study objectives are to: Design and assess the usability of the intervention for family members supporting a person being transferred from hospital to their preferred place for end of life care. Implement the intervention in hospital practice to reveal the factors that promote and inhibit implementation of the intervention; and develop toolkits to facilitate transfer of the intervention between settings. Methods The intervention integrates tested support components (reduction of uncertainty, information provision and coaching) within the framework of Family Sense of Cohesion Theory, to promote family resilience and, thereby, facilitate effective 24/7 care. The intervention has been clinically modelled with practitioners as conversational prompts, each addressing an intervention component (meaningfulness, uncertainty, comprehensibility and manageability). Using Participatory Learning and Action (PLA) methodology the study will be conducted in five developmental cycles. Results The intervention will be piloted at three clinical sites from July 2016. Following this, there will be further roll out to 7 additional sites across England (through to September 2017). References National Council for Palliative Care.Who Cares? Support for carers of people approaching the end of life. London: The National Council for Palliative Care; 2013 Waring J, Marshall F, Bishop S, et al. An ethnographic study of knowledge sharing across the boundaries between care processes, services and organisations: the contribution to 9safe9 hospital discharge. Health Services and Delivery Research 2014;2(29)

Background Palliative care remains a new discipline within Serbia, thus there is a need for a comprehensive programme of continuing education and formal higher education for palliative care (PC). Prior to 2011, there was no formal palliative care training incorporated into the undergraduate curriculum for health and social care professionals. Therefore the introduction of palliative care into the curriculum for doctors, nurses and social workers was a key component of the development of palliative care. Aim The aim was to integrate pc into the undergraduate curricula of medical, higher nursing and social work curriculum in Serbia. Methods A team of national and international experts led the process. For each discipline, contact was made with the appropriate Deans, meetings held with representatives from the different faculties, and a curriculum development process established. Existing curricula were reviewed, where they existed e.g. for the medical schools and curricula drafted based on international guidelines/experience. Results Comprehensive training materials have been developed, including facilitators guides, presentations and student handbooks, as there is no comprehensive Serbian PC book. The curriculum has been integrated into the undergraduate medical course in all five medical schools in Serbia i.e. the Universities of Belgrade, Novi Sad, Kragujevac, Nis, and the Military Medical Academy. The process of acceptance into the higher nursing schools is ongoing but it is anticipated that at least half of the schools will integrate palliative care as a mandatory course. For social workers, palliative care will be taught within the curriculum for the first time from October 2013. Conclusion Integration of pc into the undergraduate curriculum for health and social care professionals is vital in the development of pc. Working in collaboration with the different faculties is key to integration, along with development of comprehensive training materials in accordance with European and International standards.