DYING FROM HEART-DISEASE

Objectives. To describe the symptoms experienced in the last year of l ife by people with heart disease, their relation to quality of life, a nd informal carers' satisfaction with hospital services. Methods. Inte rview survey of informal carers of 600 patients aged 15 and over, appr oximately ten months after their death from heart disease in 1990 in 2 0 English health districts. The districts, while self-selected, were n ationally representative in social characteristics and indicators of h ealth service provision and use. Results. Pain, dyspnoea and low mood were reported to have been experienced by more than half the patients in their last year of life. Anxiety, constipation, nausea/vomiting, ur inary incontinence and faecal incontinence, although not suffered by t he majority of patients, also caused much distress. Hospital symptom c ontrol was reported to be limited: little or no symptom relief was rep orted for 35% patients with pain, 31% with constipation, 24% with dysp noea and 24% with nausea/vomiting. Nevertheless, high levels of satisf action with hospital staff were reported. Conclusions. Patients dying from heart disease experience a wide range of symptoms, which are freq uently distressing, and often last for more than six months. There is room for an improvement in palliative care for patients with heart dis ease in hospital.