Decision making at the nd of life for terminally ill people who live alone

Palliative care clients whp live alone have more hospital admissions for symptom management and terminal care and are less likely to die at home than those who have a carer. The aim of this study is to determine who and what influence decision making and service utilisation at the end of life for people who live alone. Obtaining this information will ascertain key areas that need to be addressed by health care professionals/service providers to assist people who live alone to maintain optimum quality of life and receive palliative symptom management and terminal care in their place of choice. Using a case study methodology seven clients who live alone were interviewed and completed questionnaires assessing psychological and functional status. In addition, their case notes were reviewed to identify discussions that occurred relating to decision making and to determine any additional services provided that may have assisted the client to remain at home if this was their wish. A self-administered questionnaire focusing on decision making and the experience of providing care to clients who live alone was provided to 45 Registered Nurses working in community palliative care. This presentation will outline the emerging factors influencing decision making from the clients' and nurses' perspectives. These factors will inform current practice.