HelpAge report highlights critical palliative care needs for older Ukrainians amid ongoing conflict

Older Ukrainians living with serious illness face significant concerns and challenges within the political, environmental, and social context of the ongoing armed conflict, according to a new report published by HelpAge International, in partnership with HelpAge USA.  

Humanitarian actors must include palliative care in their response plans and listen to the voices of older people and their caregivers to provide comprehensive home and community-based care that aligns with their preferences and needs. 

The report highlights an innovative project funded by GlobalGiving which provides palliative care services in Ukraine. It underscores the profound challenges faced by older people due to the combined toll of disease and the ongoing war, and offers key recommendations to enhance their care and support. 

“Our findings reveal the unimaginable burden faced by older people living with serious illnesses in the midst of war. We are deeply grateful for the generous support of GlobalGiving, which has allowed us to highlight these issues and work to ensure that older people’s needs and preferences are included in healthcare system planning during humanitarian crises,” said Cindy Cox-Roman, CEO and president of HelpAge USA. “The voices of older people must lead the way in developing policies and care models that uphold their dignity and well-being. Every older people facing serious illness in Ukraine has the right to live their remaining days in dignity and safety, free from fear and surrounded by people who care.” 

The report, titled “’At Home, Even the Walls Help’: Exploring the Palliative Care Needs, Experiences, Preferences, and Hopes of Older People with Serious Illness in Ukraine,” is based on interviews and focus groups with older Ukrainians living with serious illness, informal caregivers, and health and social care workers in three oblasts: Lviv, Dnipro, and Kharkiv. The interviews and focus groups were conducted by HelpAge staff in March and April 2024 and examined how pain stemming from illness is entwined with the pain of living through a devastating war. 

Key Findings 

The report reveals that the needs of older people living with serious illness are frequently unmet, leading to significant emotional and existential suffering exacerbated by the conflict. They often experience intense physical pain and debilitating anxiety compounded by war-related trauma. Many older people, including those with serious illness or those caring for someone with serious illness, have faced significant barriers to accessing essential healthcare, medicines, and assistive products during the conflict, particularly if they are immobile, displaced, isolated, or in or near active conflict zones. 

The research also finds that older people with serious illness highly value the comfort of their own homes and the support of family and community, showing a preference for home-based palliative care over institutional settings, which often deepen their sense of isolation and abandonment. In addition, research suggests that the way palliative care professionals assess, and address needs may not always match what older people say they actually want and need themselves. 

The war has severely hindered access to healthcare services, with displaced older adults struggling to find medical care in unfamiliar locations. In addition, the cost of medications and medical supplies is prohibitively expensive for many, given their limited incomes and low pensions. 

While many children and younger adults with serious illnesses, particularly cancer, have been urgently evacuated to other countries for care, older people with serious illness overwhelmingly remain in Ukraine, enduring the compound impacts of older age, illness, displacement, and war. 

Despite tremendous challenges, however, older Ukrainians and their caregivers exhibit remarkable resilience, relying on personal endurance, spirituality, and the hope of returning to their homes as key coping strategies. 

Recommendations 

Based on this research—and particularly the experiences shared by older people, their family caregivers, and health and social care workers—HelpAge has proposed recommendations on ways to improve and advance quality palliative care in Ukraine. These include the following: 

1. Integrate Palliative Care in Humanitarian Responses:
International humanitarian organisations, including UN agencies and non-governmental organisations (NGOs), must prioritise and integrate palliative care in all humanitarian response plans and funding, in line with the World Health Organization’s 2018 guidance. 

2. Sustained Funding:
Donors of humanitarian response and recovery should ensure ongoing and adequate funding to the Ukrainian government and humanitarian actors to provide palliative care and long-term support for older people with serious illnesses. 

3. Strengthened Coordination:
Enhancing the coordination between the Ministry of Health, the Ministry of Social Policy, and local health and social care departments is crucial. This should include creating seamless referral processes and structured collaboration between governmental and non-governmental organisations.  

4. Emphasis on Home-Based Care
Investments should focus on strengthening home- and community-based palliative care services as opposed to institutionalised care. This supports the preferences of older people to receive care within their own homes, fostering autonomy and community inclusion. 

5. Training and Support for Caregivers: 

It is critical to develop comprehensive training programmes for healthcare and social workers in palliative care, including modules on dealing with grief and bereavement. Additionally, it is important to provide support structures for caregivers to alleviate their burden and improve their capacity to deliver compassionate care.

6. Community-Driven Approaches: 

Regional and local health and social care departments, international humanitarian organisations, and Ukrainian local and community-based organisations should foster community-led strategies for raising awareness about the importance of palliative care for older people. They should also involve communities in co-designing care models that reflect the unique social, political, and environmental contexts within Ukraine. 

HelpAge urges governments, policymakers, and humanitarian organisations worldwide to prioritise and enhance palliative care for older individuals in Ukraine and beyond, ensuring their right to live with dignity and compassion even in the midst of crisis. 

HelpAge shared more about the programme and discussed key findings from the report at a global webinar which featured panellists Favila Escobio, HelpAge International’s humanitarian health adviser, Iryna Verveda, Health Programme Manager from HelpAge International in Ukraine, and report author Rachel Coghlan. They were joined by caregivers and older people who received palliative care services through the project in Ukraine. 

About GlobalGiving
GlobalGiving is a charity that supports other charities by connecting them to donors and companies. Since 2002, GlobalGiving has helped trusted, community-led organisations from Afghanistan to Zimbabwe (and hundreds of places in between) access the tools, training, and support they need to serve their communities and make our world a better place. Learn more at globalgiving.org.