The Location of Death and Dying Across Canada: A Study Illustrating the Socio-Political Context of Death and Dying

Abstract

Background: Concern has existed for many years about the extensive use of hospitals by dying persons. In recent years, however, a potential shift out of hospital has been noticed in a number of developed countries, including Canada. In Canada, where high hospital occupancy rates and corresponding long waits and waitlists for hospital care are major socio-political issues, it is important to know if this shift has continued or if hospitalized death and dying remains predominant across Canada. Methods: Recent individual-anonymous population-level inpatient Canadian hospital data were analyzed to answer two questions: (1) what proportion of deaths in provinces and territories across Canada are occurring in hospital now? and (2) who is dying in hospital now? Results: In 2014–2015, 43.9% of all deaths in Canada (excluding Quebec) occurred in hospital. However, considerable cross-Canada differences in end-of-life hospital utilization were found. Some cross-Canada differences in hospital decedents were also noted, although most were older, male, and they died during a relatively short hospital stay after being admitted from their homes and through the emergency department after arriving by ambulance. Conclusion: Over half of all deaths in Canada are occurring outside of hospital now. Cross-Canada hospital utilization and inpatient decedent differences highlight opportunities for enhanced end-of-life care service planning and policy advancements.

The impact of clinical internship experience on nursing students' attitudes towards death and choices of end‐of‐life care: A self‐control study

“…The choice of the palliative care/hospice ward for end‐of‐life care by nursing students was primarily influenced by the presence of professional medical services and facilities in these units, which can effectively manage symptoms and alleviate the various discomforts associated with end‐of‐life illnesses. Additionally, nursing students expressed a desire to avoid burdening their families and to prevent potential emotional trauma for their family and friends (Gomes et al., 2013 ; Nilsson et al., 2017 ; Wilson et al., 2018 ). After the internship, there was an increase of 12 individuals (12.5%) who chose the palliative care/hospice ward for end‐of‐life care and 2 individuals who chose the emergency department.…”