Preferred place of death

The preference for death at home is a key assumption of current policy. The number of home deaths is increasingly being used as a marker of service quality.

Previous studies have reported mixed findings about patient and public preferences for place of death. Surveys suggest that most people would like to die at home.

A poll conducted on behalf of DEMOS found that 66% of respondents expressed a preference to die at home.

The VOICES survey of bereaved carers found that although most patients had not expressed a preference, 71% of those who had done so indicated they wished to die at home. Although most deaths (53%) occur in hospital, this is stated to be the least preferred option for place of death.

However, qualitative studies, based on direct interviews with study participants, suggest a more varied and complex picture, and also that preferences may change over time, especially as the end of life comes nearer. For many people, place of death may not be the most important priority for end of life care.

Thomas, 2005; McCall and Rice, 2005; Gomes et al, 2006.

Evidence suggests that people vary quite widely in their preferences, and in how important they feel place of death - as opposed to place of care - to be.

‘The strength of the evidence supporting that the majority prefers home to other settings is not as strong as it once was and there is a substantial minority of patients and caregivers for whom home is not the first choice or who change their mind.'

Gomes et al, 2013:16).

D Scherer
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We have seen that there are differences in the way people express preferences for place of death. What do you think might explain these differences?


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