Perspectief 2020-48

2020-48 Assistance provision to relatives of an incurable patient 47 infrastructure for palliative care provision. Since then, the programs of training have been funded, where medical students are taught the basics of caring for incurable patients 25 . Nowadays, there are 150 different services involved in taking care of palliative patients and their relatives in the Netherlands. Most of them exist in the context of hospitals, including 62 hospital palliative care support teams and 24 inpatient palliative care units. Also, ser- vices are provided by 24 inpatient hospices and 18 home teams. Besides that, in the country, there are 13 inpatient hospices, 22 home and 7 hospital programs for incurable children and their parents 26 . ‘In the Netherlands , palliative care is an integral part of regular health care. Dutch govern- ment policy is based on the idea that palliative care is generalist care and should therefore be provided by any healthcare profes sionals whenever necessary’ 27 . Purposeful state pol- icy has proved fruitful. For instance, in 2013 the fraction of hospitals that had palliative care teams was only 39 %, for two years (up to 2015) it increased by 77% 28 . Within such a multi-disciplinary team, there are mainly medical nurses, medical staff specializing in in- ternal diseases, anesthesiologists and chaplains, etc. Most teams only function within the health care institution (in 2015, only 10 teams agreed to provide home care) and within the workday or several hours a day (only 11% of teams work 24/7) 29 . The data about the targeted assistance of those teams to patients’ closest families is highly limited 30 . It may be assumed, however, that some kind of aid to relatives is nevertheless provided. It might occur through personal contacts of team members, communication during home care ser- vices, 24/7 hotline consultations, etc. Besides hospitals, palliative care in the Netherlands is also provided in hospices. Within those institutions, cooperation between specialized health care professionals, representatives of the clergy, and volunteers is possible 31 . Here it should be indicated that the involvement of volunteers in the care of incurable patients and their family members is significant in the Dutch healthcare system. In the Netherlands, 8,000 volunteers are working in different sectors of palliative care. Out of 210 local volun- teer organizations that specialize in end of life care, 70 are taking care of hospices and 140 more provide palliative care at home. Amongst all institutions that provide home care, 75% of work is done by volunteers, and in the low care hospices 32 , they play a crucial role. Voluntary assistants take care of patients in low care hospices around the clock, as spe- cialists are present in those institutions only part-time and on call 33 . Volunteers are