New survey finds patients become increasingly interested in palliative care homes as the severity of their illness increases
A study that asked Canadians if they would prefer having their end-of-life care in a hospital versus at home has found that patients’ opinions varied with the severity of their case.
The biggest priority for these patients, according to the study, was to be with family in their dying moments.
The study, conducted by Laura Funk from the University of Manitoba and Maria Cherba from the University of Ottawa, was carried out in response to many official policies that assume most people want to age and die at home.
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“Myself and other team members have done a lot of research into the palliative care and palliative care policy,” said Funk.
“One of the things that we noticed was that a lot of key policies often made general statements about people wanting to age and die at home. And we need to support that.
“Our issue wasn’t with the need to support that process specifically,” she said. “But rather, what is the evidence and other examples of individuals who may not want to age or die in that place.”
Funk and Cherba gave survey participants both options — to stay at home or to be admitted into hospital or palliative care. The survey included three scenarios, each having a different level of severity.
“The main thing we found was that as the severity of each scenario increased, the preference for dying at home decreased, whereas preferences for dying in palliative care units or hospice long-term care increased.”
But how would these survey results change if the demographic was strictly Canadians living on farms or in rural communities?
Megan Reimer, whose family farm is north of Cupar, Sask., said she would be happiest with receiving end-of-life care in her home.
“If it needed to happen, I would prefer to be on my farm where I am comfortable and at peace,” she explained.
“I was raised there and that is where I would want things to end if I had the choice. Having also lost grandparents and other relatives that were farmers living in a palliative care home, it is obvious that they would have been happier being in their own homes.”
Reimer emphasized the importance of Canadian’s having choice, also acknowledging the need for hospice and palliative care in certain situations.
“Though palliative care is often necessary, the possibility to get a choice and be home for those final moments are definitely the way I would want to go; having familiar sounds and smells being the last thing I notice before departing.”
Following the survey, Funk and Cherba conducted open-ended interviews with participants. The interview consisted of more hypothetical situations in which a patient might rather receive their end-of-life care at home.
“We really got to talk to them about what it means to die at home,” said Funk. “Often, it was about being around family for them. That was key. So, for some people in a rural town where there is a small nursing home and people know each other, that could be defined as home for them as well.”
“Dying at home can be defined differently for some people. I do think it often comes down to that kind of connection to family in particular,” she concluded.
