Preferred Place of Death—A Study of 2 Specialist Community Palliative Care Services in Australia

Author:

Saurman Emily1ORCID,Allingham Sam2,Draper Kylie3,Edwards Julie4,Moody Jeanette3,Hooper Dawn4,Kneen Kerrie4,Connolly Jane5,Eagar Kathy2

Affiliation:

1. Department of Rural Health, University of Sydney, Broken Hill, New South Wales, Australia

2. Australian Health Services Research Institute, University of Wollongong, New South Wales, Australia

3. Eastern Palliative Care Association Incorporated, Mitcham, Victoria, Australia

4. Sydney Adventist Hospital Community, Palliative Care Service, Wahroonga, New South Wales, Australia

5. Palliative Care Outcomes Collaboration, Australian Health Services Research Institute, University of Wollongong, New South Wales, Australia

Abstract

Choice and preference are fundamental to person-centered care and supporting personal choice at the end of life should be a priority. This study analyzed the relationship between a person’s preferred place of death and other individual variables that might influence their actual place of death by examining the activity of 2 specialist community palliative care services in Australia. This was a cross-sectional study of 2353 people who died between 01 August 2016-31 August 2018; 81% died in their preferred place. Sex, type of life-limiting illness, and length of time in care were the only variables significantly related to dying in one’s preferred place. Women were more likely to die in their preferred place than men (84% v 78%) and people with a non-cancer diagnosis were 7% more likely to die in their preferred place than those with cancer, particularly when that place was their private residence (74% v 60%) or Residential Aged Care Facility (98% v 89%). Someone in care for 0-7 days had 4.2 times greater odds of dying in their preferred place (OR = 4.18, 2.20-7.94), and after 21 days in care, people had 4.6 greater odds of having a preference to die in a hospital (OR = 4.63, 3.58-5.99). Both community palliative care services have capacity and a model of care that is responsive to choice. These findings align with known referral patterns and disease trajectories and demonstrate that it is possible to support the majority of people in the care of community palliative care services to die in their preferred place.

Publisher

SAGE Publications

Subject

General Medicine

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