Background In the course of HD, both patients and their family members are confronted with several problems, both physical, psychological/emotional and social. Services that are available for them should focus on all these problems, keeping in mind that preserving autonomy and quality of life are the main goals of these services.

Aims To give an insight in the basic principles of specialised nursing home care and other services for HD patients and their families.

Results The following principles will be discussed from a Belgian and Dutch perspective:

Clustering of Patients and Expertise, Continuous Care Chains in LTC, Maintaining Autonomy and Quality of Life in a Dialogue, Advanced Care Planning, Mobility, Balance and Falls (Physical Therapy), Maintaining ADL Function (Occupational Therapy), Prevention /treatment Malnutrition and Swallowing, Behaviour: Medical and Psychological Care and Social Vulnerability

The Belgian Perspective Will Focus on Ways of Personalising Care and Living Conditions for Each Individual Patient and Throughout the whole disease process, through dialogue with and support for the patient and his family. the Dutch perspective will give examples of high expertise professional care, but also aimed at autonomy and quality of life.

Conclusion The complexity of the social, medical and psychological problems of (advanced) HD patients requires comprehensive long term care services. With two different international perspectives, topics will be comprehensively discussed that help to pursue the highest achievable quality of life.