Factors determining the place of palliative care and death of cancer patients

Abstract

Factors determining the place of palliative care and death were studied by interviewing 40 patients using a semi-structured questionnaire. The 86 interviews assessed showed that both emotional and somatic factors played a part in the determination of whether patients were transferred and of their place of death. Emotional factors were mentioned in 41% as being of importance, and physical factors in 32%. Material and financial factors are probably underestimated owing to the methodology.

Where do the elderly die? The impact of nursing home utilisation on the place of death. Observations from a mortality cohort study in Flanders

“…In a survey on oncological services in the district of Antwerp, 77% of the cancer patients died in hospital, 3% in a nursing home and 20% at home [ 16 ]. A comparable distribution of place of death in the general population as in our study was observed in 2001 in the German speaking part of Switzerland, where death occurred most frequently in hospital (37.2%) followed by a nursing home (33.5%) and dying at home (22.7%) [ 17 ].…”

“…Those dying at older age were the least likely to die in a hospital but were more likely to die in a nursing home. Much of the discussion about care of the dying focuses on deaths from cancer [ 9 - 11 , 17 ]. In a survey on oncological services in the district of Antwerp, 77% of the cancer patients died in hospital, 3% in a nursing home and 20% at home [ 16 ].…”

Testing models of care for terminally ill people who live alone at home: is a randomised controlled trial the best approach?

“…This is challenging for service providers due to an ageing population that is often characterised by multiple morbidities, a lack of family carers and an increase in people living alone at home who require care (Australian Institute of Health and Welfare 2003, National Centre for Social and Economic Modelling 2004, , Aoun et al 2007. A national scoping study in Australia investigated the needs and issues of palliative care patients living alone , confirming previous reports that people living alone with a terminal illness had more hospital admissions and were less likely to die at home than those with family carers (Hinton 1994, Grande et al 1998, Higginson et al 1998, Karlsen & Addington-Hall 1998, Jordhøy et al 2000, Van den Eynden et al 2000, Brazil et al 2002, Gyllenhammar et al 2003, Grundy et al 2004.…”

Next‐of‐kin caregivers in palliative home care – from control to loss of control

“…Many researchers describe the pressure placed on nextof-kin caregivers during palliative home care, but only a few have explored the actual reasons for the discontinuance of home care (Van den Eynden et al 2000, Gyllenhammar et al 2003 and no study was found that illustrates this phenomenon using a qualitative approach. According to Gyllenhammar et al (2003), next-of-kin and home care personnel indicate that the primary reasons for discontinuation of home care are factors in connection with lack of symptom control, and medical treatments and complications that cannot be managed in the home.…”