Death from cancer and death from other causes: the relevance of the hospice approach

Abstract

An interview survey of people who knew a random sample of adults who died in 1987 is reported, with analysis focusing on the differences between those dying of cancer and other causes in the context of the debate about the relevance of the hospice approach to noncancer patients. Age is identified as a key variable determining the family composition: people dying of cancer, being younger on average than people dying of other conditions, are more likely to be able to draw upon family members for help. The pattern of symptoms and restrictions in cancer suggests an illness which has a relatively short but intense period of suffering and dependency, compared to the longer duration of these periods in average noncancer deaths. Existing health service provision reflects this. Not only is a diagnosis of dying more difficult in the absence of cancer, but the communication issues are often less clear-cut because of the presence of long-term mental confusion. The focus of the hospice movement on the control of particular symptoms and on the support of family members is considered in the light of these differences.