Care of the dying patient in the community

Collis, Emily; Al-Qurainy, Rasha

doi:10.1136/bmj.f4085

Cited by 27 publications

(20 citation statements)

References 40 publications

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“…In total, 69.3% who wanted to die at home were able to achieve this preference which compares favourably with available literature. Recent studies5 9 11 12 suggest that involvement of community specialist palliative care teams increases the possibility that patients may achieve their preference for end-of-life care at home.…”

Section: Discussionmentioning

confidence: 99%

“…Advance care planning (ACP) including exploring end-of-life care and place of death with patients increases the probability an individual will achieve this preference 9 10. Other factors which influence preferred place of death include age, gender, living with relatives, low functional status and cancer diagnosis 9.…”

Section: Discussionmentioning

confidence: 99%

“…Other factors which influence preferred place of death include age, gender, living with relatives, low functional status and cancer diagnosis 9. The support through involvement and awareness of preferences by the GP also increases the possibility of the patient achieving their preference 13.…”

Section: Discussionmentioning

confidence: 99%

“…The absence of medication was not identified as a precipitant during this 5-year period, indeed the majority of home deaths did have anticipatory medication in place. Many different systems exist across the UK,1 9 16 using a framework to support best practice appears effective in achieving quality and location of death, for example, in care homes 17. The University Health Board supports designated pharmacists in each locality to stock such anticipatory medication to avoid delays in access.…”

Section: Discussionmentioning

confidence: 99%

“…Studies suggest preferences for place of death may differ from place of care 7. Patients are known to change their preference for place of death during their illness trajectory 8 9. Opportunities to discuss these preferences were already part of communication with the patient.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The importance of identifying preferred place of death

Ali

Capel²,

Jones

et al. 2015

BMJ Support Palliat Care

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ObjectivesThe majority of people would prefer to die at home and the stated intentions of both statutory and voluntary healthcare providers aim to support this. This service evaluation compared the preferred and actual place of death of patients known to a specialist community palliative care service.DesignAll deaths of patients (n=2176) known to the specialist palliative care service over a 5-year period were examined through service evaluation to compare the actual place of death with the preferred place of death previously identified by the patient. Triggers for admission were established when the patients did not achieve this preference.ResultsBetween 2009 and 2013, 73% of patients who expressed a choice about their preferred place of death and 69.3% who wanted to die at home were able to achieve their preferences. During the course of their illness, 9.5% of patients changed their preference for place of death. 30% of patients either refused to discuss or no preference was elicited for place of death.ConclusionsDirect enquiry and identification of preferences for end-of-life care is associated with patients achieving their preference for place of death. Patients whose preferred place of death was unknown were more likely to be admitted to hospital for end-of-life care.

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Section: Discussionmentioning

confidence: 99%