Palliative care – what exactly is it?
The aim of palliative care is to relieve pain, thereby improving the quality of life of the person in care and generally to improve the quality of life of the person in care through a multidisciplinary approach.
Palliative care is defined by the law as « active care, continuous and co-ordinated, undertaken by a multidisciplinary team with due regard to the respect and dignity due to the person in care. Palliative care aims to cover all physical, psychological and spiritual needs and to support those close to the patient. It includes the treatment of pain and psychological suffering ».
Am I covered for palliative care?
Everyone in an advanced or terminal phase of a serious illness is entitled to palliative care.
Voted on the 18th December 2008, the Law from 16th March 2009 concerning palliative care, advanced directives and end-of-life accompaniment lays down the rights of persons in an advanced or terminal phase of a serious and incurable illness. One of the underlying principles of this Law allows for access of all end-of-life patients to palliative care.
Who can apply for palliative care?
The doctor treating the end-of-life patient can and must submit a formal request for palliative care to the Medical Board of the Social Security (CMSS).
The right to palliative care is acquired with the declaration presented by the treating doctor on a form specifically intended for this purpose, consisting of an administrative section and a medical one. The declaration is signed by the treating doctor and addressed to the Medical Board of the Social Security (Contrôle médical de la sécurité sociale CMSS) in a sealed envelope. It must then be validated by the CMSS.
How can I be sure that palliative care will be approved?
After the application has been submitted, the treating doctor, the person in care and the care providers involved, will be promptly notified of the decision by post.
The declaration is approved and validated by the CMSS. The dates for the beginning and the ending of palliative care are stated in the certificate of coverage and communicated to the patient, the doctor who submitted the initial request, and the care providers known at the time the request was filed.
When exactly does the right to palliative care begin?
Entitlement to palliative begins on the date determined by the CMSS, based on the date given on the declaration, submitted by the treating doctor.
Entitlement to palliative care expires after 35 days of acquiring it. In exceptional cases, it may be prolonged for one or more additional periods of 35 days.
Who submits the request for a renewal of palliative care?
The treating doctor of the person in end-of-life care can and must submit a request for a necessary prolongation of care to the CMSS.
Entitlement to palliative care expires after 35 days of acquiring it. In exceptional cases, it may be prolonged for one or more additional periods of 35 days.
Who creates the palliative care dossiers at the CNS?
The service « Autorisations – Soins palliatifs » creates each dossier. Where necessary, the document is subsequently linked to a long-term care insurance dossier.
What is the health care booklet for?
The care booklet serves as a tool to enable all professionals involved in a patient's care to liaise, communicate and connect with one another.
The booklet can be seen as an instrument, a means of ensuring continuity in the way the person in care is looked after; it informs the different care providers about the care which has already been delivered.
Is there a specific procedure for settling invoices?
No.
The usual ways of settling invoices apply.
What coverage is offered for palliative care?
The law relating to palliative care builds on the legislation relating to health and long-term care insurances currently applicable. The existing laws concerning health insurance and long-term care insurance were adapted and simplified, to best suit the needs of the person at the end of their life.
Health insurance
Medical services listed by the health insurance are covered, in accordance with the rules laid down in the CNS statutes.
Long-term care insurance
When someone is admitted to palliative care, they are entitled to assistance and care provided by the long-term care insurance.
What happens if I am already receiving benefits from the long-term care insurance?
The right to receive benefits from the long-term care insurance is not affected.
Where can palliative care be delivered?
Palliative care is provided in a hospital, in an approved establishment in accordance with the Laws relating to health and long-term care insurances, or even at home.
If you wish to remain at home, or return home after a hospital stay, you may continue to benefit from palliative care and assistance in your normal living environment through a network of assistance and care which provide services at home.
Where can I obtain more information?
As far as your specific personal situation is concerned, your treating doctor is the best person to answer your questions. However, the CNS is also at your disposal to answer any queries.
For a general overview, please consult the Guide to Palliative Care « Guide des soins palliatifs », (available in French) published by The Ministry of Health, the Ministry of Social security and the Ministry of Family and Integration and available on our website. It also offers a useful list of addresses.
Is it necessary to file a request for the long-term care insurance in order to ensure that a patient can take advantage of services covered by the long-term care insurance if they begin to receive palliative care?
No.
Approval for coverage relating to palliative care covers the costs listed by both the health and long-term care insurances.