Predictors of home death in palliative care cancer patients

With recent changes in health care there is greater emphasis on providing c are at home, including the support of families to enable more home deaths. Since a home death may not be practical or desirable in every family situat ion, there is a need for an objective way to assess the viability of a home death in each individual family situation. The purpose of this study was t o describe the relative role of predictors of home death in a cohort of pal liative care patients with advanced cancer. A questionnaire was created as a means of assessing the viability of a home death. Five questions were inc luded. Ninety questionnaires were administered by home care coordinators. A follow-up questionnaire was administered to record the place of death. Of the 73 evaluable patients, 34 (47%) died at home and 39 (53%) died in hospi tal or hospice. The desire for a home death by both the patient and the car egiver, support of a family physician, and presence of more than one caregi ver were all significantly associated with a home death. Logistic regressio n identified a desire for home death by both the patient and the caregiver as the main predictive factor for a home death. The presence of more than o ne caregiver was also predictive of home death. The questionnaire is simple and, if our results are confirmed, it can be used for predicting those who will not have a home death.