Abstract
Background/aims: During the covid-19 pandemic, the number of home deaths increased as people avoided institutionalised settings. The research investigates the changing profile of place of death and the impact it has on the future of hospice services.
Methods: Mixed methods:
(1) systematic review to understand the evidence base around place of care preferences;
(2) analysis of mortality data to show the percentage increase in home deaths and highlight peaks;
(3) interviews with 37 participants (15 carers and 22 hospice staff) to explore reasons behind the decision-making and identify impact on quality of life using the ICECAP-CPM. Results were discussed at two stakeholder roundtable events to draw out policy and practice implications for hospice care.
Results: There was a significant change in place of death towards home deaths for those dying from non-covid related conditions. Increased hospital deaths were more closely linked to the presence of covid on the death certificate. Risk factors associated with hospital deaths included black and minority ethnic groups, lower socio-demographic factors and the presence of an underlying health conditions such as cardiovascular disease and diabetes. Qualitative data analysis reveals that preferences around decision-making to be cared for at home were due to a fear of contracting the virus in institutionalised settings (hospices and hospitals) and visiting restrictions. Quality of life remained high for hospice inpatient and community patients showing good symptom control and communication but concerns were raised about dignity, coping, being with people who care and feeling supported during the main lockdown period. Policy roundtables identified the need for better workforce support and systems of community support for carers.
Conclusions: It is timely to address the future of ’hospice’ and explore how services can better support people in communities who are the main providers of end-of-life care and support the changing hospice workforce.
Methods: Mixed methods:
(1) systematic review to understand the evidence base around place of care preferences;
(2) analysis of mortality data to show the percentage increase in home deaths and highlight peaks;
(3) interviews with 37 participants (15 carers and 22 hospice staff) to explore reasons behind the decision-making and identify impact on quality of life using the ICECAP-CPM. Results were discussed at two stakeholder roundtable events to draw out policy and practice implications for hospice care.
Results: There was a significant change in place of death towards home deaths for those dying from non-covid related conditions. Increased hospital deaths were more closely linked to the presence of covid on the death certificate. Risk factors associated with hospital deaths included black and minority ethnic groups, lower socio-demographic factors and the presence of an underlying health conditions such as cardiovascular disease and diabetes. Qualitative data analysis reveals that preferences around decision-making to be cared for at home were due to a fear of contracting the virus in institutionalised settings (hospices and hospitals) and visiting restrictions. Quality of life remained high for hospice inpatient and community patients showing good symptom control and communication but concerns were raised about dignity, coping, being with people who care and feeling supported during the main lockdown period. Policy roundtables identified the need for better workforce support and systems of community support for carers.
Conclusions: It is timely to address the future of ’hospice’ and explore how services can better support people in communities who are the main providers of end-of-life care and support the changing hospice workforce.
| Original language | English |
|---|---|
| Pages (from-to) | 43-43 |
| Number of pages | 1 |
| Journal | Palliative Medicine |
| Volume | 37 |
| Issue number | 1S |
| DOIs | |
| Publication status | Published - 7 Jun 2023 |
| Event | 18th EAPC World Congress - Rotterdam, Netherlands Duration: 15 Jun 2023 → 17 Jun 2023 |
