title: Hospice Care for Children With Cancer: Where Do These Children Die?
abstract: Hospice is an important provider of end of life care; many children who die of cancer enroll in hospice programs. How frequently such children remain in hospice to die at home, or disenroll from hospice and die in the hospital, has not been described. A child's location of death has important implications for quality of life and parental adaptation. This represents a subanalysis of a retrospective study of 202 consecutive oncology patients who died at a single center between January 1, 2006 and December 31, 2010. Of 95 children who enrolled in hospice, 82 had known location of death. Sixty (73%) died at home or an inpatient hospice unit, 15 (18%) died in the oncology unit, 5 (6%) died in the intensive care unit, and 2 (2%) died in the emergency department. The median length of hospice services was 41 days, twice the national median of 21 days reported in adults. One quarter of children disenrolled from hospice care, ultimately dying in an acute care setting. Further studies are warranted to explore the hospice experience in children, and to address modifiable factors that may impact a family's choice to withdraw from hospice care.
authors.affiliation: *Department of Anesthesiology †Cancer and Blood Disease Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH ‡Department of Clinical Sciences §Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center ∥Children's Medical Center Dallas ¶Department of Pediatrics, Pauline Allen Gill Center for Cancer and Blood Disorders, Division of Hematology-Oncology, University of Texas at Southwestern Medical Center, Dallas, TX.
authors.forename: Rachel
authors.initials: R
authors.lastname: Thienprayoon
authors.forename: Simon C
authors.initials: SC
authors.lastname: Lee
authors.forename: David
authors.initials: D
authors.lastname: Leonard
authors.forename: Naomi
authors.initials: N
authors.lastname: Winick
mesh_terms: D002648:Child; D017051:Hospice Care / Q000706:statistics & numerical data*; D006801:Humans; D009369:Neoplasms; D010372:Pediatrics / Q000706:statistics & numerical data*; D012189:Retrospective Studies