Where the Dying Live: A Systematic Review of Determinants of Place of End-of-Life Cancer Care

Abstract

Findings may highlight evidence-based interventions to assist patients and families facing decisions regarding place of EOL care. A clearer understanding of factors that influence place of EOL care for patients with cancer could enhance healthcare policy and guide needs-based modifications of the healthcare system.

Use of Opioid Analgesics Among Older Persons With Colorectal Cancer in Two Health Districts With Palliative Care Programs

“…Enrollment in PCPs may increase a person's likelihood of dying at home, 45 which is often reported as the preferred location of death by persons with cancer. 46,47 Access to strong opioids in long-term care also may enable residents to die in place at the care facility, rather than be transferred to acute hospital settings. The observed negative association with in-hospital death is consistent with the interpretation that accessing opioids in the community facilitates dying in place.…”

Factors Related to Spirituality for Terminally ill Cancer Patients through Life Review Interview in Japan

“…95% (18), spiritual care 84% (16), and help with grieving 58% (11). Just as in the first and second questions, respondents were invited to write in needs that could not be addressed in their clinical setting.…”

“…The survey was developed for this study by the research team from a review of hospice and palliative care literature about the needs of people with advanced cancer (Figure 1) [15][16][17]. Three fixed-item questions asked respondents to identify (1) the needs of men with advanced prostate cancer, (2) which of the needs (identified in Question 1) could be met in their clinical setting, and (3) which of the needs identified in (Question 1) could not be met in their clinical setting.…”

“…Emotional and psychosocial needs of survivors with advanced prostate cancer and their caregivers are also very significant and may not always given the same priority as the physical needs. Important psychosocial needs for patient, intimate partner and other caregivers include support with decision-making [9,10], management of depression and anxiety, emotional support for changes in intimacy and sexual relationships [11][12][13][14], and identification of community resources [15,16], financial assistance, and assistance with advance care planning [15][16][17].…”

“…Given the complex needs of men with advanced prostate cancer survivors and their caregivers [4][5][6][10][11][12][13][14][15][16], it is important to know which needs can be met by health care providers and the needs that cannot be addressed in these clinical settings. Identification of these unmet needs can inform the development of interventions to support men with advanced prostate cancer and their caregivers and supplement the care that is being provided.…”