Dying at home: enablers and barriers
Anna Dowd, Melanie J. Davies, Sarah M. Short, Ruth Morrison, Cheryl Spiller, Jill Carter, Peter Eastman
Abstract
BACKGROUND: According to the Grattan institute in 2014, 70% of Australians indicated a preference to die at home, however, only 14% of all deaths were at home. AIMS: To identify how patients can be supported to die at home if that is their preference. METHODS: A retrospective medical record audit of eligible Community Palliative Care (CPC) patients who indicated a wish to die at home was undertaken. FINDINGS: Out of a total of 114 patients, 74% indicated a preference to die at home. Of these, 66% achieved a home death, and most lived with a carer. Enablers for home death included family support, regular nursing visits and equipment. People who attended an emergency department in their last month of life, lived alone or were undergoing oncological treatment were more likely to die elsewhere. CONCLUSION: A range of enablers and barriers to home death were found, with many of the enablers being factors that prevented hospital presentations.