Abstract

Background: Dying patients would prefer to die at home, and therefore a goal of end-of-life care is to offer choice regarding where patients die. However, whether it is feasible to offer this option to patients within critical care units and whether teams are willing to consider this option has gained limited exploration internationally. Aim: To examine current experiences of, practices in and views towards transferring patients in critical care settings home to die. Design: Exploratory two-stage qualitative study Setting/participants: Six focus groups were held with doctors and nurses from four intensive care units across two large hospital sites in England, general practitioners and community nurses from one community service in the south of England and members of a Patient and Public Forum. A further 15 nurses and 6 consultants from critical care units across the United Kingdom participated in follow-on telephone interviews. Findings: The practice of transferring critically ill patients home to die is a rare event in the United Kingdom, despite the positive view of health care professionals. Challenges to service provision include patient care needs, uncertain time to death and the view that transfer to community services is a complex, highly time-dependent undertaking. Conclusion: There are evidenced individual and policy drivers promoting high-quality care for all adults approaching the end of life encompassing preferred place of death. While there is evidence of this choice being honoured and delivered for some of the critical care population, it remains debatable whether this will become a conventional practice in end of life in this setting.

DOI

10.1177/0269216314560208

Publication Date

2015-04-01

Publication Title

Palliative Medicine

Volume

29

Issue

4

Publisher

SAGE Publications

ISSN

1477-030X

Embargo Period

2024-11-19

First Page

354

Last Page

362

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