Many older adults, especially those with chronic end-of-life illnesses, prefer to remain and die in the comfort of their own home rather than in an unfamiliar institutional setting, and a new study shows that if these very ill patients get frequent visits from hospice nurses and doctors, they’re more likely to be able to do so.
The findings highlight the importance of hospices, which provide specialized care to very sick or terminally ill patients and offer them the opportunity to remain at home if they want to.
“Frankly, it’s one of the things hospices offer that hospitals can’t,” said Dr. David Casarett, chief medical officer at the Penn-Wissahickon Hospice at the University of Pennsylvania in Philadelphia.
“People want to be home,” he told Reuters Health. “That’s where they feel comfortable and it’s a matter of dignity.”
In the Journal of Clinical Oncology, Casarett and his colleagues write that the majority of cancer patients die in a hospital even though most would prefer to do so at home.
“Most people now have an option, so it’s really important for people to achieve that option,” said Donna Wilson, a professor at the University of Alberta in Canada, who was not involved with the new study.
The study’s authors looked at information collected for cancer patients in hospices in Florida, Pennsylvania, and Wisconsin between October 2008 and June 2011. Out of those, patient medical records indicated that more than 5,800 of them wanted to die, and about three-quarters of those wanted to die at home, while the rest typically preferred to die at a nursing home, hospital, or hospice unit.
Out of those who started care at home and indicated a preference to die there, 55% did so, with researchers tying people’s chances of dying at home with three factors: being married, having an advanced directive clearly stating a preference, and getting daily visits from hospice for the first four days of their care.
The results of the study don’t necessarily prove that frequent visits by hospice professionals increase the chance of dying according to an individual’s preferences, the researchers say, but they believe it can improve those chances.
“The main finding for us was the issue of being able to show that more visits really do help,” Casarett is quoted as saying in the Reuters article. “It’s not really rocket science – it’s common sense in a way. But, from a policy perspective, it’s important.”
Written by Alyssa Gerace