Comparative study of perceptions of family members to the end-of-life care in residential care facilities and hospitals in Tampere, Finland

Abstract

Objective: Current trend in long-term care (LTC) is to bring the care to the place where the person lives and to avoid unnecessary transitions. The purpose of the study was to find out family members' opinions about the quality of end-of-life care in LTC compared to care in hospitals. Methods: A postal questionnaire was sent to the family members of 168 residents, who had died during the year 2012 in LTC in Tampere, southern Finland. Results: A total of 97 family members (58%) returned the questionnaire. Eighty-two percent of the residents suffered from dementia. Family members seemed to be more satisfied with the care if the resident had died in LTC. Family members reported that residents who had died in LTC were more often kept clean (80% vs. 55%; p = .020), their dignity was maintained more often (84% vs. 56%; p = .021) and their wishes considering their care were acknowledged better (82% vs. 50%; p = .033) compared to the residents that died in a hospital. Residents who died in LTC suffered also less from agitation (32% vs. 60%; p = .047). The trend in the prevalence of other signs and symptoms and the prevalence of non-palliative interventions was lower, if the resident had died in LTC. Conclusions: Family members perceived the quality of end-of-life care given in residential care facilities to be at least as good, or, in some cases, better than the quality of end-of-life care given in a hospital.

Changes in place of death among people with dementia in Finland between 1998 and 2013: A register study

“…Lehmus et al. [24] found that family members thought that patients in an LTC care facility (sheltered housing with 24-hour assistance) in Finland received higher quality end-of-life care than those who died in a hospital. Thus, the decreasing number of deaths in hospital and increasing number of deaths in LTC facility during the study years may suggest an improvement in the end-of-life care setting.…”