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Article History

Received: 12 March 2019

Accepted: 5 August 2019

First Online: 30 August 2019

Ethics approval and consent to participate

: Ethics approval from the relevant ethics committees were obtained in all participating countries. Belgium: Commissie Medische Ethiek UZBrussel, 27/05/2015; England: NHS – NRES Committee North West-Haydock, 10/09/2015; Finland: Terveyden jahyvinvoinnin laitos, Institutet för hälsa och välfärd, 30/6/2015; Italy: Comitato Etico, Universita Cattolica del Sacro Cuore, 6/11/2017; Netherlands: Medisch Ethische Toetsingscommissie VUMedisch Centrum, 2/7/2015; Poland: Komisja Bioetycza, Uniwersytetu Jagiellonskiego, 25/6/2015; Switzerland: Commission cantonale d’éthique de la recherché scientifique de Genève (CCER), 6/8/2015.All persons participating in the study (facility managers, care staff, GPs) have to give their prior informed consent in writing. If residents are unable to give informed consent, they will not be involved in the study. In some countries, a separate informed consent from individual participants is not required if questionnaires are filled in anonymously: for the Netherlands, the Medical Ethics Review Committee concluded that this study does not fall under the Medical Research Involving Human Subjects Act (WMO). In accordance with the Dutch code for good practice in biomedical research, a separate informed consent was not needed. The Polish Ethical Committee stated no separate informed consents were needed given the study design protected anonymous answering of individual respondents. Returning the questionnaire was regarded as consent to participate in the study.

: Not applicable.

: The authors declare that they have no competing interests.