| Key factors identified to allow cancer patients to die at home
Well over half of people with a progressive illness want to die at home and several countries are making substantial reforms to enhance home care. But despite these efforts, most people die in hospitals in many countries, including Italy. To
determine what factors influence where patients with cancer die, we
carried out an in-depth analysis of 58 studies from the last 30 years
involving 1.5 million patients in 13 countries, nearly 30,800 patients in
Italy. The analysis revealed many important factors that affect where
people die, but the main ones include whether the patient has limited
activity or function, whether they have expressed a preference to die at
home, the availability and level of home care and the presence of live-in
relatives or extended family to provide support. Based
on the evidence, we recommended a ‘five-pronged approach’ to ensure
that people access home care services and get the intensive support they
need. As well as families having more say and support in what happens,
there should be public education about the issue, continued effort to
improve home care facilities, early risk assessment and palliative care
training for nurses and home-helps as well as experts. This model represents an evidence based answer to the rights of terminally ill patients to die at home with dignity. We strongly encourage its use in the development and evaluation of future strategies by policy makers to enable more home deaths and by practitioners to enable their patients to die at home if they wish so. Bibliographical
reference Barbara
Gomes, Irene Higginson The Cicely Saunders Foundation and Department of Palliative Care, Policy and Rehabilitation at King’s College London, UK
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