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Where to die? That is the question: A study of cancer patients in Israel

Published online by Cambridge University Press:  13 February 2014

Frida Barak*
Affiliation:
Oncology Institute and Department of Social Services, Barzilai Medical Center, Ashqelon, Israel and Affiliated with Ben-Gurion University of the Negev, Faculty of Health Sciences, Beer-Sheva, Israel
Sofia Livshits
Affiliation:
Oncology Institute and Department of Social Services, Barzilai Medical Center, Ashqelon, Israel and Affiliated with Ben-Gurion University of the Negev, Faculty of Health Sciences, Beer-Sheva, Israel
Haana Kaufer
Affiliation:
Oncology Institute and Department of Social Services, Barzilai Medical Center, Ashqelon, Israel and Affiliated with Ben-Gurion University of the Negev, Faculty of Health Sciences, Beer-Sheva, Israel
Ruth Netanel
Affiliation:
Oncology Institute and Department of Social Services, Barzilai Medical Center, Ashqelon, Israel and Affiliated with Ben-Gurion University of the Negev, Faculty of Health Sciences, Beer-Sheva, Israel
Nava Siegelmann-Danieli
Affiliation:
Maccabi Healthcare Services, Oncology Service Line, Tel Aviv, Israel
Yasmin Alkalay
Affiliation:
Department of Sociology, Tel Aviv University, Tel Aviv, Israel
Shulamith Kreitler
Affiliation:
School of Psychological Sciences, Tel-Aviv University, Tel Aviv, Israel and Psychooncology Research Center, Sheba Medical Center, Tel-Hashomer, Israel and Affiliated with Sackler School of Medicine, Tel Aviv, Israel
*
Address correspondence and reprint requests to: Frida Barak, Director, Oncology Institute, Barzilai Medical Center, Ashqelon, Israel. E-mail: barakfrida@gmail.com; fridab@barzi.health.gov.il

Abstract

Objective:

Most patients prefer to die at home, but barely 30% do so. This study examines the variables contributing to dying at home.

Methods:

The participants were 326 cancer patients, of both genders, with a mean age of 63.25 years, who died from 2000 to 2008 and were treated by the palliative care unit of the Barzilai Hospital. Some 65.7% died at home and 33.4% in a hospital. The data were extracted from patient files. The examined variables were demographic (e.g., age, gender, marital status, ethnic background, number of years in Israel until death), medical (e.g., age at diagnosis, diagnosis, nature of last treatment, patient received nursing care, patient given the care of a social worker, patient had care of a psychologist, family received care of a social worker, patient had a special caregiver), and sociological (e.g., having insurance, having worked in Israel, living alone or with family, living with one's children, living in self-owned or rented house, family members working).

Results:

The findings indicate that the chances of dying at home are higher if the patient is non-Ashkenazi, the family got social worker care, the patient lived in a self-owned house, the patient lived with his family, the family members worked, and the patient's stay in Israel since immigration was longer. Logistic regression showed that all the predictors together yielded a significant model accounting for 10.9–12.3% of the variance.

Significance of results:

The findings suggest that dying at home requires maintaining continued care for the patient and family in a community context.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2014 

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References

REFERENCES

Alsirafy, S.A., Mesidy, S.M. & Abou-Elela, E.N. (2010). Where do Egyptian palliative care patients with cancer die? American Journal of Hospice and Palliative Care, 27, 313315.CrossRefGoogle ScholarPubMed
Arad, H., Geva, H., Rosin, V., et al. (1999). Home palliative care of terminal cancer patients with family feedback: From the experience of the decision to continue the community care service in the North. Harefuah, 16(136), 757–662, 844.Google Scholar
Cherny, N.I., Coyle, N. & Foley, K.M. (1996). Guidelines in the care of the dying cancer patient. Hematology Oncology Clinics of North America, 10, 261286.CrossRefGoogle ScholarPubMed
Choi, J., Miyashita, M., Hirai, K., et al. (2010). Preference of place for end-of-life cancer care and death among bereaved Japanese families who experienced home hospice care and death of a loved one. Supportive Care in Cancer, 18, 14451453.Google Scholar
Devlin, M. & McIlfatrick, S. (2009). The role of the home-care worker in palliative and end-of-life care in the community setting: A literature review. International Journal of Palliative Nursing, 15, 526532.Google Scholar
Foreman, L.M., Hunt, R.W., Luke, C.G., et al. (2006). Factors predictive of preferred place of death in the general population of South Australia. Palliative Medicine, 20, 447453.CrossRefGoogle ScholarPubMed
Gagnon, B., Mayo, N.E., Hanley, J., et al. (2004). Pattern of care at the end of life: Does age make a difference in what happens to women with breast cancer? Journal of Clinical Oncology, 22, 34583465.Google Scholar
Gilbar, O. & Steiner, M. (1996). When death comes: Where should patients die? Hospital Journal, 11, 3148.Google Scholar
Gomes, B. & Higginson, I.J. (2006). Factors influencing death at home in terminally ill patients with cancer: Systematic review. British Medical Journal, 332, 515.CrossRefGoogle ScholarPubMed
Gott, M., Seymour, J., Bellamy, G., et al. (2004). Older people's views about home as a place of care at the end of life. Palliative Medicine, 18, 460467.CrossRefGoogle ScholarPubMed
Higginson, I.J. & Sen-Gupta, G.J.A. (2000). Place of care in advanced cancer: A qualitative systematic literature review of patient preferences. Journal of Palliative Medicine, 3, 287300.Google Scholar
Higginson, I.J., Astin, P. & Dolan, S. (1998). Where do cancer patients die? Ten-year trends in the place of death of cancer patients in England. Palliative Medicine, 12, 353363.Google Scholar
Hinton, J. (1994). Can home care maintain an acceptable quality of life for patients with terminal cancer and their relatives? Palliative Medicine, 8, 183196.Google Scholar
Houttekier, D., Cohen, J., Bilsen, J., et al. (2010). Place of death in metropolitan regions: Metropolitan versus non-metropolitan variation in place of death in Belgium, The Netherlands and England. Health & Place, 16, 132139.CrossRefGoogle ScholarPubMed
Marie Curie Cancer Care (2004). Supporting the choice to die at home: Campaign briefing. London: Marie Curie Cancer Care.Google Scholar
Murray, M., O'Connor, A.M, Fiset, V., et al. (2003). Women's decision-making needs regarding place of care at end of life. Journal of Palliative Care, 19, 176184.Google Scholar
Nanda, A., Bourbonniere, M., Wetle, T., et al. (2010). Home care in the last year of life: Family member perceptions of unmet need associated with last place of care. Journal of The American Medical Directors Association, 11, 2125.Google Scholar
Reich, O, Signorell, A. & Busato, A. (2013). Place of death and health care utilization for people in the last 6 months of life in Switzerland: A retrospective analysis using administrative data. BMC Health Service Research, 25(13.1), 116. Epub ahead of print: PubMed PMID: 23530717.CrossRefGoogle Scholar
Sharp, L., Foll, P., Deady, S., et al. (2010). Where do people with lung cancer die and how is this changing? A population-based study. Irish Medical Journal, 103, 262264, 266.Google Scholar
Storey, L., Pemberton, C., Howard, A., et al. (2003). Place of death: Hobson's choice or patient choice? Cancer Nursing Practice, 2, 3338.Google Scholar
Tang, S.T. (2003). When death is imminent: Where terminally ill patients with cancer prefer to die and why. Cancer Nursing, 26, 245251.Google Scholar
Wheatley, V.J. & Baker, J.I. (2007). “Please, I want to go home”: Ethical issues raised when considering choice of place of care in palliative care. Postgraduate Medical Journal, 63, 643648.CrossRefGoogle Scholar
Wilkinson, S. (2000). Fulfilling patients' wishes: Palliative care at home. International Journal of Palliative Nursing, 6, 212.Google Scholar