Short Report: Preferences for location of death of seriously ill hospitalized patients: perspectives from Canadian patients and their family caregivers

Abstract

Previous studies involving palliative patients suggest a preference for dying at home. The purpose of this paper is to examine, prospectively, patient and family caregiver preferences for, and congruence with, location of death for hospitalized patients with cancer and end-stage medical conditions. Questionnaires were administered to 440 eligible in-patients and 160 family caregivers in five hospitals across Canada. This paper reports results of 138 patient/family caregiver dyads who answered a question about preference for location of death. The results suggest that only half of all patients and family caregivers report a preference for a home death. Furthermore, half of the patient/family caregiver dyads disagree on preferred location of death. If one of the primary goals of end of life care is to enhance the quality of life of dying patients and their family caregivers, policies directed towards ensuring that patients die in their location of choice ought to be a priority and resources should be allocated to promote the development of excellent care, not only in the home, but also within our institutional settings. Palliative Medicine 2008; 22: 85—88

Keywords

end of life family caregivers location of death seriously ill-hospitalized patients

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References

Higginson IJ , Sen-Gupta GJA Place of care in advanced cancer: a qualitative systematic literature review of patient preferences . J Palliat Med 2000; 3(3): 287—300.

Pritchard RS , Fisher ES , Teno JM et al. Influences of patient preferences and local health system characteristics on the place of death . J Am Geriatr Soc 1998; 46: 1242—50.

Tang ST Determinants of hospice home care use among terminally ill cancer patients . Nurs Res 2003; 52(4): 217—25.

Dudgeon D. , Kristjanson L. Home vs. hospital death: assessment of preferences and clinical challenges . CMAJ 1995; 152: 337—40.

Harding R. , Higginson I. Working with ambivalence: informal caregivers of patients at the end of life . Support Care Cancer 2001; 9(8): 642—5.

Stajduhar KI Examining the perspectives of family members involved in the delivery of palliative care at home . J Palliat Care 2003; 19: 27—35.

Stajduhar KI , Davies B. Variations and factors influencing family members' decisions for palliative home care . Palliat Med 2005; 19(1): 21—32.

Heyland DK , Dodek P. , Rocker G. et al. for the Canadian Researchers at the End of Life Network (CARENET). What matters the most in end-of-life care: perceptions of seriously ill patients and their family members . CMAJ 2006; 174: 627—33.

Heyland DK , Frank C, Groll et al. for the Canadian Researchers at the End of Life Network (CARENET). Understanding cardiopulmonary resuscitation decision making: perspectives of seriously ill hospitalized patients and family members . Chest 2006; 130(2): 419—28.

10.

Heyland DK , Groll D. , Rocker G. et al. for the Canadian Researchers at the End of Life Network (CARENET).

End of life care in acute care hospitals in Canada. A quality finish?

J Palliat Care 2005; 21(3): 142—50.

11.

Cohen J. Weighted kappa: nominal scale agreement with provision for scaled disagreement or partial credit . Psychol Bull 1968; 70(4): 213—20.

12.

Seale C. , Addington-Hall J. , McCarthy M. Awareness of dying: prevalence, causes and consequences . Soc Sci Med 1997; 45(3): 477—84.

13.

Aoun SM , Kristjanson LJ , Currow D. , Hudson P.

Caregiving for the terminally ill: at what cost?

Palliat Med 2005; 19: 551—5.

14.

Haley WE , LaMonde LA , Han B. , Narramore S. , Schonwetter R. Family caregiving in hospice: effects on psychological and health functioning among spousal caregivers of hospice patients with lung cancer or dementia . Hosp J 2001; 15(4): 1—18.

15.

McCorkle R. , Pasacreta JV Enhancing caregiver outcomes in palliative care . Cancer Control 2001; 8(1): 36—45.

16.

Thomas C. , Morris SM , Clark D. Place of death: preferences among cancer patients and their carers . Soc Sci Med 2004; 58: 2431—44.