title: End of life in intensive care: is transfer home an alternative?
abstract: The past decade has witnessed an increased focus on improving the quality of end of life care internationally. This has resulted in the development of specific health policy work streams to support patient choice and improve standards of care and patient experience. One concept well explored in areas outside of critical care is that of home care at the end of life. This paper seeks to challenge assumptions and practices about the options for transferring the critically ill patient home at end of life. As a piece of collaborative writing from a bereaved family member and critical care nursing team, this paper explores care given to one gentleman at the end of his life. In this, his journey is detailed, the decisions made are outlined and the experience for him and his family are examined with a retrospective narrative account from his wife that is woven throughout the paper. In this paper, we are not asserting that transfer home at end of life is desirable or feasible for all critically ill patients. We are challenging practitioners to consider when and how the initiative of transferring critically ill patients home at end of life, may occur.
authors.affiliation: E Level Cardiac Unit, Southampton General Hospital, Southampton SO16 6YD, United Kingdom. Lynda.Tellett@suht.swest.nhs.uk
authors.forename: Lynda
authors.initials: L
authors.lastname: Tellett
authors.forename: Lynne
authors.initials: L
authors.lastname: Pyle
authors.forename: Maureen
authors.initials: M
authors.lastname: Coombs
mesh_terms: D006330:Heart Defects, Congenital; D006699:Home Care Services; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D010347:Patient Care Planning; D057240:Patient Preference; D010360:Patient Transfer; D011368:Professional-Family Relations; D013727:Terminal Care; D006113:United Kingdom