Current State of Home Palliative Care and Factors Influencing Death at Home for Terminally Ill Cancer Patients Living in Single-person Households

ABSTRACT

Purpose: This study investigated the current state of medical care and palliative care provided at home and the factors influencing death at home for terminally ill cancer patients living in single-person households. Methods: We conducted a retrospective questionnaire study of 1032 cancer patients living in single-person households who received home palliative care from 17 specialized home care clinics and finished home care between June and November 2013. We compared patient background factors, outcomes, home care services, and medical care between these patients and others not living in single-person households to investigate factors influencing death at home. Results: Compared with patients not living in single-person households, the patients living in single-person households were older, had a better performance status at initiation of home palliative care, showed a lower preference for dying at home, and received more frequent social hospitalization. Among the subjects from single-person households, factors influencing death at home were a family preference for dying at home (odds ratio (OR)=14.0), poor performance status at initiation of home palliative care (OR=4.0), and no hospitalization during home palliative care (OR=16.6). Conclusion: We found that death at home for terminally ill cancer patients living in single-person households and receiving home medical care and palliative care was influenced by family preference, the performance status at initiation of home palliative care, and hospitalization during home palliative care.