A comparison of patients dying at home and patients dying at a hospice: sociodemographic factors and caregivers' experiences.
OBJECTIVE
The aim of this study was to investigate whether there were any differences between patients who died at home and patients who died at a hospice, that is, sociodemographic variables, the family caregivers' experiences of burden, and their opinion of reasons for hospice care.


METHODS
The study comprises a consecutive sample of family caregivers to adult patients: (I) who were cared for by the advanced palliative home care team (APHCT) and died at home, (II) who were cared for by the APHCT and died at the Hospice, (III) who were cared for and died at the Hospice in Uppsala during a period of one year. A questionnaire was mailed to caregivers and the medical records of all the patients were analyzed.


RESULTS
The place of death differed significantly and varied according to gender and cohabitation status. Men died to a greater degree at home compared with women. The family caregivers' experiences of burden were moderate. Caregivers of patients who died at home thought that this care form has a more positive influence on the patients' quality of life than was the case in the other groups. They were also more satisfied with their own achievement. The caregivers' opinion of why patients needed hospice care was nearly the same in groups II + III, acutely developing symptoms being the most common reason.


CONCLUSIONS
This study showed that women died to a lesser degree at home than men. The explanation for this is unknown and requires further investigation. It is important to establish whether female patients or male caregivers need another type of support than male patients or female caregivers, since the aim of palliative care is that every patient who wishes to die at home should have this wish fulfilled.
Carlsson
Maria E
ME
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. maria.clarlsson@pubmed.uu.se
Rollison
Britta
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D003643:Death; D003657:Decision Making; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data*; D006738:Hospices / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D018709:Statistics, Nonparametric; D013548:Sweden