Author
- Joachim Cohen1
- Vrije Universiteit Brussel1
2015
Excerpt
Despite a majority preferring not to die in hospital and health policies aimed at increasing home death, the proportion of hospital deaths remains high in many countries. This implies that studies in palliative and end-of-life care should not solely focus on the homelike environment as a place of end-of-life care but also gain insight into perceptions of the acute hospital setting as a place of terminal care and into the reasons, the appropriateness and avoidability of hospitalisations at the very end of life. This presentation will present qualitative (focus groups and interviews) and quantitative (survey among family physicians about those of their patients who had died non-suddenly in an acute university hospital setting) study results from Belgium to address the following questions:
1. What are the perspectives of family physicians, nurses and family carers of hospital as a place of death?
2. What are their perspectives concerning hospital admissions at the end of life and the circumstances in
which they consider them to be justified?
3. What are the reasons for hospital admissions at the end of life?
4. What is their perceived inappropriateness or avoidability; and which interventions could have prevented them?
The findings indicate that a large majority of terminal hospital admissions is considered to be appropriate and unavoidable by the family physicians. On the other hand, hospital is often perceived as an inappropriate place for end-of-life care while 55% of the terminal acute hospital admissions was for reasons of palliative care. A number of implications from the findings will be discussed, including possible strategies to reduce the number of terminal hospital admissions.
1. What are the perspectives of family physicians, nurses and family carers of hospital as a place of death?
2. What are their perspectives concerning hospital admissions at the end of life and the circumstances in
which they consider them to be justified?
3. What are the reasons for hospital admissions at the end of life?
4. What is their perceived inappropriateness or avoidability; and which interventions could have prevented them?
The findings indicate that a large majority of terminal hospital admissions is considered to be appropriate and unavoidable by the family physicians. On the other hand, hospital is often perceived as an inappropriate place for end-of-life care while 55% of the terminal acute hospital admissions was for reasons of palliative care. A number of implications from the findings will be discussed, including possible strategies to reduce the number of terminal hospital admissions.