'It all depends!': A qualitative study of preferences for place of care and place of death in terminally ill patients and their family caregivers.

Abstract:

BACKGROUND:It is often suggested that terminally ill patients favour end-of-life care at home. Yet, it is unclear how these preferences are formed, if the process is similar for patients and family caregivers, and if there are discrepancies between preferences for place of care and place of death. Understanding these nuances is essential to support people in their decision-making and ultimately provide better care at the end-of-life. AIM:To gain an in-depth understanding of how terminally ill patients and their family caregivers make decisions about preferred place of care and place of death. DESIGN:Semi-structured interviews with patients and family caregivers, which were analysed thematically using qualitative description. SETTING/PARTICIPANTS:A total of 17 participants (8 patients and 9 caregivers) recruited from an acute palliative care hospital ward, a sub-acute hospice unit, and a palliative homecare organisation in Melbourne, Australia. RESULTS:The process of forming location preferences was shaped by uncertainty relating to the illness, the caregiver and the services. Patients and caregivers dealt with this uncertainty on a level of thoughts, emotions, and actions. At the end of this process, patients and caregivers expressed their choices as contextual, personal, relational, conditional and flexible preferences. CONCLUSIONS:These findings suggest that in many cases end-of-life decision-making does not conclude with a clear and stable choice. Understanding the reasons for the malleability of preferences and the process of how they are formed has implications for both clinicians and researchers.

journal_name

Palliat Med

journal_title

Palliative medicine

authors

Gerber K,Hayes B,Bryant C

doi

10.1177/0269216319845794

subject

Has Abstract

pub_date

2019-07-01 00:00:00

pages

802-811

issue

7

eissn

0269-2163

issn

1477-030X

journal_volume

33

pub_type

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