Factors predictive of preferred place of death in the general population of                 South Australia

Foreman, Linda M; Hunt, Roger; Luke, Colin; Roder, David

doi:10.1191/0269216306pm1149oa

Cited by 158 publications

(182 citation statements)

References 23 publications

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“…These concerns have also been reported by other patient groups. 12,21 Although there is conflicting evidence about the quality of care received in inpatient settings versus at home, 2 some patients perceive that having access to professional medical care in inpatient settings is essential. People may also feel a sense of security from receiving care at a hospital with which they are already familiar.…”

Section: Discussionmentioning

confidence: 99%

“…2 In one US study of terminally ill patients with cancer, perceived quality of life, the availability and capacity of family carers, the impact their choice would have on others, and quality of healthcare were major considerations in preference. 12 Greater understanding of patient choices and the underlying reasons for these choices can help inform the development of more effective, patientcentered care models that may be more widely available and integrated across care settings. 2 To do this, patients must be given opportunities to articulate and implement their choice through proper discussions with key individuals, including healthcare providers and support persons.…”

mentioning

confidence: 99%

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The Right Place at the Right Time: Medical Oncology Outpatients' Perceptions of Location of End-of-Life Care

Waller¹,

Sanson‐Fisher²,

Zdenkowski³

et al. 2018

J Natl Compr Canc Netw

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Background: Helping people achieve their preferred location of care is an important indicator of quality end-of-life (EOL) care. Using a sample of Australian medical oncology outpatients, this study examined (1) their preferred location of EOL care; (2) their perceived benefits and worries of receiving care in that location; (3) the percentage who had discussed preferences with their doctor and/or support person; and (4) whether they wanted their doctor to ask them where they wanted to die. Methods: Adults with a confirmed diagnosis of cancer were approached between September 2015 and January 2016 in the waiting room of an Australian oncology outpatient clinic. Consenting participants completed a home-based pen-and-paper survey indicating preferred location of care, perceived benefits and worries of that location, whether they had discussed preferences with their doctors, and whether they were willing to be asked about their preferences. Results: A total of 203 patients returned the survey (47% of those eligible). Less than half preferred to be cared for at home (47%), 34% preferred a hospice/palliative care unit, and 19% preferred the hospital. Common benefits and worries associated with locations included perceived burden on others, familiarity of environment, availability of expert medical care, symptom management, and likelihood of having wishes respected. More patients had discussed preferences with their support persons (41%) than doctors (7%). Most wanted a doctor to ask them about preferred location of care (87%) and thought it was important to die in the location of their choice (93%). Conclusions: Patients were willing to have clinicians to ask them where they wanted to die, although few had discussed their preferences with doctors. Although home was the most preferred location for many patients, the overall variation suggests that clinicians should adopt a systematic approach to eliciting patient preferences. J Natl Compr Canc Netw 2018;16(1):35-41 doi: 10.6004/jnccn.2017.7025 Research into location of end-of-life (EOL) care offers insight into whether people are accessing resources that aim to improve quality of dying and support appropriate service planning. 1 A recent population-level study of patients with cancer in 14 countries reported that between 12% and 57% of patients die at home and between 22%

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The Right Place at the Right Time: Medical Oncology Outpatients' Perceptions of Location of End-of-Life Care

Waller¹,

Sanson‐Fisher²,

Zdenkowski³

et al. 2018

J Natl Compr Canc Netw

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“…A populationbased survey in Australia determined factors associated with preferred death place, with 2657 respondents asked to imagine they were dying of a terminal illness. 17 This study revealed 70% wanted at the time of death to be at home, 19% in hospital, 10% in a hospice, and 1% in a nursing home. 17 Six factors predicted a home death preference: younger age, male, born in Ireland/UK or Italy/Greece, better physical health, poorer mental health, and having few concerns about home deaths.…”

Section: Literature Reviewmentioning

confidence: 99%

“…17 This study revealed 70% wanted at the time of death to be at home, 19% in hospital, 10% in a hospice, and 1% in a nursing home. 17 Six factors predicted a home death preference: younger age, male, born in Ireland/UK or Italy/Greece, better physical health, poorer mental health, and having few concerns about home deaths. 17 A more recent public survey was conducted in Japan to clarify preferences among representative 40-79 year-olds for place of death and EOL care.…”

Section: Literature Reviewmentioning

confidence: 99%

The Preferred Place of Last Days: Results of a Representative Population-Based Public Survey

Wilson

Cohen

Deliens

et al. 2013

Journal of Palliative Medicine

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Background: The place of death is of considerable interest now, yet few studies have determined public preferences for place of end-of-life (EOL) care or final days of life. Objective: A survey was designed to answer three questions: (1) What are public preferences for the place of last days? (2) Is this place preference related to socio-demographic and other background characteristics? and (3) Is this place preference associated with specified previous death and dying experiences, the preparation of a living will or advance directive, or a viewpoint supportive of death hastening? Design: An experienced telephone survey company was commissioned to gain a representative populationbased sample and survey participants. In mid-2010, 1203 adults were surveyed in Alberta. Descriptive statistics and multinomial logistic regression were conducted. Results: This survey revealed 70.8% preferred to be at home near death; while 14.7% preferred a hospice/ palliative care facility, 7.0% a hospital, and 1.7% a nursing home; 5.7% had no stated preference. Marital status was the only predictor of place preference, with widowed persons more often indicating a preference for a hospital or hospice/palliative care facility. Conclusions: These findings suggest homes are the preferred EOL place now for the majority of Albertans, if not other citizens, while at the same time suggesting that marital and living arrangement realities temper EOL place choices and possibilities, with widows best realizing the need for assistance from others when dying. The widespread preference for home-based EOL care indicates public health interventions are needed to promote good home deaths.

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“…There is also a discrepancy between what patients report as their preferred place of death (most often home) and actual place of death (Beccaro et al 2006;Bruera et al 2003;Burge et al 2003;Foreman et al 2006;gilbar and steiner 1996;karlsen and Addington-Hall 1998;Mcwhinney et al 1995;Heyland et al 2000;Pritchard et al 1998). People who die in institutions such as acute care facilities have unmet needs for symptom control, physician communication, emotional support and respectful treatment compared with those receiving patientcentred palliative care services at home (Teno et al 2004).…”

Section: Résumémentioning

confidence: 99%

Factors Associated with End-of-Life Health Service Use in Patients Dying of Cancer

Barbera¹,

Sussman²,

Viola³

et al. 2010

hcpol

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This study describes acute care hospital death, physician house calls and home care near the end of life among patients who died of cancer and the factors that are associated with these events and services. It is a population-based retrospective study that uses linked administrative healthcare data. The cohort includes all patients who died of cancer between 2000 and 2004 in Ontario, Canada.Fifty-five per cent of patients died in acute care hospital, 68% received home care in the last 6 months of life and 24% received at least one physician house call in the last 2 weeks of life. Increased age was associated with a decreased likelihood of each event or service. women were less likely to die in acute care and more likely to receive home care. Residents in low-income neighbourhoods were less likely to receive house calls or home care. Patients who received home care or house calls were less likely to die in acute care.Our observations add to those in the literature, suggesting a need to increase the use of supportive care services at the end of life in hopes of decreasing the need for acute care. They also serve as a baseline for future comparison, which is of particular interest since new government policies directed at end-of-life care were recently introduced.

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Factors predictive of preferred place of death in the general population of South Australia

Cited by 158 publications

References 23 publications

The Right Place at the Right Time: Medical Oncology Outpatients' Perceptions of Location of End-of-Life Care

The Right Place at the Right Time: Medical Oncology Outpatients' Perceptions of Location of End-of-Life Care

The Preferred Place of Last Days: Results of a Representative Population-Based Public Survey

Factors Associated with End-of-Life Health Service Use in Patients Dying of Cancer

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