![]() Tang found that pain was more likely for patients who died at home (compared to hospital), while Escobar Pinzon et al. However, findings on symptoms and family outcomes are inconsistent, particularly for two widely researched outcomes: pain and grief. There is some evidence showing better results on psychological, social, and holistic measures of well-being in the last weeks or days of life for patients dying at home compared to hospital. ![]() Population ageing and larger numbers of people dying from cancer represent a demographic imperative for healthcare systems to ensure a dignified death for all. Furthermore, the most important aim towards the end of life is to ensure the best possible palliative outcomes. Despite differing trends, the most frequent location of death for those dying from cancer is hospital, with marked variations in the odds of home death depending on illness-related, individual, and environmental factors. In Japan, Germany, Greece, and Portugal a trend towards institutionalised dying persists. In the UK, the US, and Canada, more appear to be realising this wish. Studies of patients with advanced cancer and the general public show that most people would prefer to die at home. ![]() National Institute of Health Research (NIHR) Clinical Research Network Portfolio. The study suggests that dying at home is better than hospital for peace and grief, but requires a discussion of preferences, GP home visits, and relatives to be given time off work. Grief was less intense for their relatives than for those of patients who died in hospital ( β, –0.15 around time of death and –0.14 at questionnaire completion, P = 0.02). Adjusting for confounders, patients who died at home experienced similar pain levels but more peace in their last week of life (ordered log odds ratio 0.69, P = 0.007). Dying in hospital was associated with more hospital days, fewer general practitioner (GP) home visits, and fewer days taken off work by relatives. The propensity of death at home also increased when the relative was aware of incurability and the patient discussed his/her preferences with family. Four factors explained >91 % of home deaths: patient’s preference, relative’s preference, home palliative care, or district/community nursing. Where people died was, for most (80 %), the place where they lived during their last week of life. We determined factors influencing death at home, and associations between place of death and pain, peace, and grief. Bereaved relatives identified from death registrations completed a questionnaire including validated measures of patient’s pain and peace in the last week of life and their own grief intensity. Mortality follow-back study of 352 cancer patients who died in hospital (n = 177) or at home (n = 175) in London, UK. This study aims to determine the association between place of death, health services used, and pain, feeling at peace, and grief intensity. However, not all have equal chances and the evidence is unclear on whether dying at home is better. Studies show that most patients with advanced cancer prefer to die at home.
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