Quick Study

Study: Dying at home may be less traumatic for patients as well as caregivers

Monday, September 27, 2010; 6:48 PM

Dying at home may be less traumatic for patients as well as their caregivers

THE QUESTION Some people with a terminal illness spend their last days at home, perhaps with hospice services. Others die in an intensive-care unit or other hospital locale. Might the location have an effect on the person who's dying or on the person's caregivers?

THIS STUDY involved 333 adults with terminal cancer and an equal number of caregivers (spouses, adult children, other relatives or friends). Most cancer patients died about 41/2 months after enrolling in the study. Fifty-nine percent died at home with hospice care and 7 percent died at home without it; 26 percent died in a hospital and 8 percent in an ICU. Among those who died in an ICU or hospital, the quality of their life at the end was rated as lower, with more physical and emotional stress, than it was for those who died at home, with or without hospice care. Among the caregivers, those whose loved ones did not die at home faced a greater risk of psychological problems within six months of the death than did those whose loved ones died at home: They were about five times more likely to have post-traumatic stress disorder (21 percent vs. 4 percent) and about four times more likely to have prolonged grief (22 percent vs. 5 percent).

WHO MAY BE AFFECTED? People with a terminal illness and their caregivers, who need to make choices about treatment.

CAVEATS Patients' quality of life was assessed by their caregivers and may not have reflected people's true levels of distress. The authors theorized that results were better for those cared for at home and their caregivers because hospice and other home-care services emphasize making the person comfortable whereas hospital and ICU care "often focuses on keeping patients alive at all costs," which they say can be traumatic for all. Study participants were paid $25.

FIND THIS STUDY Sept. 13 issue of the Journal of Clinical Oncology.

LEARN MORE ABOUT end-of-life care at www.cancer.gov (search for "last days"). Learn about hospice at www.mayoclinic.com.

- Linda Searing

The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.

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