Preferred versus actual place of death: a hospital palliative care support team experience

TLDR

The study prospectively examined the place of death for 160 patients referred to a hospital support team. Among these patients, 62 % died in hospital, 26 % at home, and 12 % in hospice; 56 % expressed a preferred place (48 home, 26 hospice), 71 % of whom achieved it, while the remainder died in hospital due to illness progression or logistical barriers, highlighting limited choice for non‑malignant cases and distress when patients were sent to hospice against their wishes.

Abstract

A prospective study of the place of death of 160 patients referred to a hospital support team was carried out. Of these patients 62% died in hospital, 26% at home and 12% in a hospice. Overall, 56% of patients (90) were able to express a preference for place of death; 48 patients wished to die at home and 26 wanted to be cared for in a hospice. 71 % of these patients achieved their choice but the remainder became too unwell to transfer and died in hospital. Thirteen patients chose to die in hospital; other reasons for death in hospital included unexpected deterioration while undergoing active treatment or investigations (33), relatives unable to cope with home care (27) and late presentation precluding transfer (12). The lack of choice for some patients dying of nonmalignant disorders is highlighted and attention is drawn to the distress of patients sent to a hospice against their choice.