title: Preferred place of death for patients referred to a specialist palliative care service.
abstract: OBJECTIVE
  Understanding patients' preferences for place of death and supporting patients to achieve their wishes has become a priority. This study aims to: (1) examine preferences of patients referred to a specialist palliative care service; (2) determine whether preferences of those who have been admitted as hospice inpatients differ from those who have not; (3) identify reasons why preferred place of death (PPD) is sometimes not recorded; and (iv) investigate whether nominating a PPD relates to actual place of death.
  
  
  METHODS
  PPD information was collected as part of standard care for all patients referred to a specialist palliative care service. Case notes were reviewed retrospectively for 1127 patients who died under the care of the service.
  
  
  RESULTS
  Seventy-seven percent of the patients expressed a PPD, a further 21% of patients had documented reasons for PPD remaining unknown. Eighty percent of patients who had never been admitted to the hospice wanted to die at home. In contrast, 79% of those with at least one hospice inpatient admission wanted to die in the hospice. Patients who had an unknown PPD were three times more likely to die in hospital.
  
  
  CONCLUSIONS
  Most patients in a specialist palliative care setting are willing to express a PPD. Preferences differ for patients who had never been admitted as hospice inpatients from those who have had at least one inpatient stay. Routine and ongoing assessment of PPD are recommended to support patients' wishes at the end of life.
authors.affiliation: Marie Curie Hospice Edinburgh, Edinburgh, UK.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Arnold
authors.affiliation: Marie Curie Hospice Edinburgh and University of Edinburgh, Edinburgh, UK.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Finucane
authors.affiliation: Marie Curie Hospice Edinburgh, Edinburgh, UK.
authors.forename: David
authors.initials: D
authors.lastname: Oxenham
mesh_terms: D000368:Aged; D001293:Attitude to Death; D005260:Female; D017051:Hospice Care / Q000523:psychology*; D006738:Hospices / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010166:Palliative Care / Q000523:psychology*; D057240:Patient Preference / Q000523:psychology*; D012189:Retrospective Studies; D012606:Scotland
keywords: home; hospice; preferred place of care (PPC); preferred place of death (PPD); specialist palliative care