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. 2015 Sep;5(3):294-6.
doi: 10.1136/bmjspcare-2012-000338. Epub 2013 May 27.

Preferred place of death for patients referred to a specialist palliative care service

Elizabeth Arnold  1 , Anne M Finucane  2 , David Oxenham  1
Affiliations

Preferred place of death for patients referred to a specialist palliative care service

Elizabeth Arnold et al. BMJ Support Palliat Care. 2015 Sep.

Abstract

Objectives: Understanding patients' preferences for place of death and supporting patients to achieve their wishes has become a priority. This study aims to: (1) examine preferences of patients referred to a specialist palliative care service; (2) determine whether preferences of those who have been admitted as hospice inpatients differ from those who have not; (3) identify reasons why preferred place of death (PPD) is sometimes not recorded; and (iv) investigate whether nominating a PPD relates to actual place of death.

Method: PPD information was collected as part of standard care for all patients referred to a specialist palliative care service. Case notes were reviewed retrospectively for 1127 patients who died under the care of the service.

Results: Seventy-seven percent of the patients expressed a PPD, a further 21% of patients had documented reasons for PPD remaining unknown. Eighty percent of patients who had never been admitted to the hospice wanted to die at home. In contrast, 79% of those with at least one hospice inpatient admission wanted to die in the hospice. Patients who had an unknown PPD were three times more likely to die in hospital.

Conclusions: Most patients in a specialist palliative care setting are willing to express a PPD. Preferences differ for patients who had never been admitted as hospice inpatients from those who have had at least one inpatient stay. Routine and ongoing assessment of PPD are recommended to support patients' wishes at the end of life.

Keywords: home; hospice; preferred place of care (PPC); preferred place of death (PPD); specialist palliative care.

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References

    1. Smith R. A good death. BMJ 2000;320:129. - PMC - PubMed
    1. Ellershaw J, Dewar S, Murphy D. Achieving a good death for all. BMJ 2010;341:c4861. - PubMed
    1. Department of Health. End of Life Care Strategy—Promoting high quality care of all adults at the end of life. 2008.
    1. Scottish Government. Living and dying well: a national action plan for end of life care in Scotland. Edinburgh: The Scottish Government, 2008.
    1. Gomes B, Calanzani N, Higginson I. Local preferences and place of death in regions within England. London: Cicely Saunders Institute, 2011.

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