Factors Influencing Decision-Making of Terminally Ill Cancer Patients and Their Families Regarding Where to Stay and Receive Final-Month Care: A Preliminary Study

Abstract

Background:Advance care planning is essential for a better terminal phase, although many patients do not make a choice regarding the place of receiving terminal care even one month before the expected end of life. This study explores the factors that influence patients with a life-expectancy of less than one month when they are admitted to the palliative care ward or other terminal care institutions.Methods: Self-administered questionnaire surveys were completed by patients and caregiver questionnaire surveys were completed by patients and caregivers. We assessed patient symptoms using Support Team Assessment Schedule-Japan (STAS-J), and all patients’ families answered the self-reported questionnaire, Caregiver Reaction Assessment-Japan (CRA-J).Results: The family care burden score for “Impact on schedule” was significantly higher for the palliative care ward inpatient group than for the non-inpatient group (21.0±1.5 vs. 17.6±1.8; ρ <0.01).Conclusions: Family burden might influence the choice of facility when patients with a survival prognosis of less than one month are admitted to the palliative care ward for reducing the burden of long-term care. Nurses should take care of family caregiver’s physical and psychosocial health, especially before the patient’s admission to the palliative care ward. The results of this study show that caregiver support is needed to reduce the feeling of family burden related to impact on schedule, enabling them to choose the best place for terminal care.