Palliative care
Palliative care aims to provide comprehensive coverage for patients with serious or terminal illnesses, relieving pain and improving quality of life.
This approach places the patient at the centre of care, taking into account their physical, psychological and social needs.
On this page, healthcare professionals will find essential information on the implementation of palliative care.
Everything you need to know
- In practice
- Frequently asked questions
- Useful forms and documents
- Legal references
- Request for palliative care
- Duration of the right
- Handing over the care booklet
- Managment of care booklet
- Continuity of care
The right to palliative care is granted upon declaration by the attending physician using a specific form consisting of two parts:
- an administrative section and
- a medical section.
Once completed, the declaration must be sent in a sealed envelope by the attending physician to the Social Security Medical Board (CMSS).
The right to palliative care is authorised for an initial period of 35 days from the date of commencement.
In exceptional cases, this right may be extended for one or more additional periods of 35 days.
After validating the declaration, the National Health Fund (Caisse nationale de santé, CNS) sends the attending physician a care booklet accompanied by a certificate of coverage confirming entitlement to palliative care.
The attending physician gives this booklet to the various providers involved in the care of the person receiving care.
Each service provider involved in the care of the person being cared for must record the supplies, acts and services provided in the care booklet.
The care booklet must always remain with the person being cared for and accompany them wherever they go.
The patient and care providers must have access to the care booklet at all times.
If the patient changes their place of residence, the attending physician in charge at the time of transfer is responsible for ensuring continuity of access to the care booklet for new healthcare providers involved in the patient's care.
Palliative care – what exactly is it?
Palliative care aims to relieve pain in order to improve quality of life and is designed to improve the quality of life of patients through multidisciplinary coverage.
According to the law, ‘palliative care is active, continuous and coordinated care provided by a multidisciplinary team with respect for the dignity of the person being cared for. It aims to cover all the physical, psychological and spiritual needs of the person being cared for and to support their family and friends. It includes the treatment of pain and psychological suffering.’
Who is insured for palliative care?
Who can request palliative care?
The attending physician of the person at the end of life can and must submit a request to the Social Security Medical Board (Contrôle médical de la sécurité sociale-CMSS).
The right to palliative care is granted upon declaration by the attending physician on a special form comprising an administrative section and a medical section. The declaration must be sent by the attending physician who signed the form to the Social Security Medical Board in a sealed envelope. The declaration is validated by the Social Security Medical Board.
How can I be sure that palliative care is authorised?
After the application has been submitted, the attending physician, the person receiving care and the healthcare providers concerned are quickly informed of the decision by post.
The declaration is validated by the Social Security Medical Board. A certificate of coverage stating the start and end dates of palliative care is sent to the patient, the doctor who submitted the application and the care providers known at the time of the declaration.
When does entitlement to benefits begin?
Entitlement begins on the date set by the Social Security Medical Board based on the date indicated by the attending physician on the declaration.
Entitlement to benefits expires after 35 days but may, in exceptional cases, be extended for one or more additional periods of 35 days.
Who makes the request for renewal of palliative care?
The attending physician of the person at the end of life can and must submit any necessary request for extension to the Social Security Medical Board (CMSS).
Entitlement to benefits expires after 35 days but may, in exceptional cases, be extended for one or more additional periods of 35 days.
Who creates palliative care files at the CNS?
A palliative care file is created by the "Service Autorisations – Soins palliatifs" .
This file is then linked to a long-term care insurance file if necessary.
What is the care booklet for?
The care booklet serves as a tool for liaison, communication and coordination between all professionals involved in the person's care.
The booklet is intended as a tool to ensure continuity in the care provided to the person by enabling the various professionals involved to be informed about what has been done for the person.
Is there a special procedure for invoices?
No.
The usual invoicing terms and conditions remain applicable.
What services are provided as part of palliative care?
The law on palliative care is based on existing legislation on health insurance and long-term care insurance. The existing rules on health insurance and long-term care insurance have been adapted and simplified to better meet the needs of people at the end of their lives.
Health and maternity insurance
Medical acts covered by health insurance are provided in accordance with the rules laid down in the statutes of the National Health Fund.
Long-term care insurance
When a person is admitted to palliative care, they are entitled to assistance and care under long-term care insurance.
What happens if you are already receiving long-term care benefits?
The rights acquired by the beneficiary of long-term care insurance benefits are maintained.
Where can palliative care be provided?
Palliative care is provided in hospitals, in facilities approved under health insurance and long-term care insurance laws, or at home.
If you wish to remain at home or return home after a hospital stay, you are entitled to palliative care and round-the-clock support in your usual place of residence through a network of home care and support services.
Where can palliative care be provided? Who can I contact for more information?
The attending physician will answer questions to the best of their ability based on the individual situation. The CNS is also available for any further information.
For general information, the ‘Guide to Palliative Care’, (Guide des soins palliatifs) published jointly by the Ministry of Health, the Ministry of Social Security and the Ministry of Family and Integration, is also available on the website. It includes a list of useful addresses.
Is it necessary to apply for long-term care insurance in order for the patient/insured person to receive the relevant benefits if they are admitted to palliative care?
No.
Authorisation for coverage of palliative care covers both the health insurance and long-term care insurance components.
Legal references
- Règlement grand-ducal du 28 avril 2009 précisant les modalités d’attribution du droit aux soins palliatifs
- Loi du 16 mars 2009 relative aux soins palliatifs, à la directive anticipée et à l’accompagnement en fin de vie
- Le carnet de soins avec l'attestation de prise en charge documentant le droit aux soins palliatifs
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