title: End-of-life care and achieving preferences for place of death in England: results of a population-based survey using the VOICES-SF questionnaire.
abstract: OBJECTIVE
  Health policy places emphasis on enabling patients to die in their place of choice, and increasing the proportion of home deaths. In this article, we seek to explore reported preferences for place of death and experiences of care in a population-based sample of deaths from all causes.
  
  
  METHODS
  Self-completion post-bereavement survey.
  
  
  METHODS
  Census of deaths registered in two health districts between October 2009 and April 2010. Views of Informal Carers - Evaluation of Services Short Form was sent to each informant (n = 1422; usually bereaved relative) 6-12 months post-bereavement.
  
  
  RESULTS
  Response was 33%. In all, 35.7% of respondents reported that the deceased said where they wanted to die, and 49.3% of these were reported to achieve this. Whilist 73.9% of those who were reported to have a preference cited home as the preferred place, only 13.3% of the sample died at home. Cancer patients were more likely to be reported to achieve preferences than patients with other conditions (p < .01). Being reported to have a record of preferences for place of death increased the likelihood of dying at home (odds ratio = 22.10). When rating care in the last 2 days, respondents were more likely to rate 'excellent' or 'good' for nursing care (p < .01), relief of pain (p < .01) and other symptoms (p < .01), emotional support (p < .01) and privacy of patient's environment (p < .01) if their relative died in their preferred place.
  
  
  CONCLUSIONS
  More work is needed to encourage people to talk about their preferences at the end of life: this should not be restricted to those known to be dying. Increasing knowledge and achievement of preferences for place of death may also improve end-of-life care.
authors.affiliation: 1Faculty of Health Sciences, University of Southampton, Southampton, UK.
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Hunt
authors.forename: Natalie
authors.initials: N
authors.lastname: Shlomo
authors.forename: Julia
authors.initials: J
authors.lastname: Addington-Hall
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D002423:Cause of Death; D004739:England; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D012044:Regression Analysis; D012111:Residence Characteristics; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Bereavement; health survey; palliative care; questionnaire; terminal care