• Nathan Davies, Laura Maio, Jasper van Riet Paap, Elena Mariani, Birgit Jaspers, Ragni Sommerbakk, Daniela Grammatico, Jill Manthorpe, Sam Ahmedzai, Myrra Vernooij-Dassen, Steve Iliffe, and IMPACT research team.
• a Research Department of Primary Care and Population Health , University College London , London , UK.
• Aging Ment Health. 2014 May 1; 18 (4): 400-10.

ObjectivesThere 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.MethodOne 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.ResultsThe 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.ConclusionThese 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.

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