HealthDay News — Families of patients dying of cancer believe their loved one had better care and quality of life when they died in a hospice rather than in a hospital’s intensive care unit, according to research published in the Jan. 19 issue of the Journal of the American Medical Association, a theme issue on death, dying, and end of life.
Alexi Wright, MD, MPH, an associate professor of medicine at Harvard Medical School in Boston, and colleagues collected data on 1146 cancer patients. The investigators used data from interviews with family members of Medicare patients with advanced lung or colorectal cancer from a study of patients who died by the end of 2011.
Relatives reported a better end-of-life experience more often when their loved one received hospice care for more than 3 days (58.8%) than those who received hospice care for 3 or fewer days (43.1%). Moreover, only 45.0% of families reported excellent care when the patient was admitted to a hospital intensive care unit (ICU) within 30 days of dying. The researchers also found that only 42.2% of families of patients who died in the hospital said their loved one had excellent end-of-life care, compared with 57.4% of families whose loved ones died at home or in a hospice. In addition, family members of patients who did not receive hospice care or received 3 or fewer days of hospice care were less likely to report the patient died in their preferred location (40.0%) than those who received hospice care for more than 3 days (72.8%).
“Efforts to increase earlier hospice enrollment and avoid ICU admissions and hospital deaths are important areas to focus on to improve the quality of end-of-life care,” Wright told HealthDay.
Wright AA, Keating NL, Ayanian JZ, et al. Family Perspectives on Aggressive Cancer Care Near the End of Life. JAMA. 2016; doi:10.1001/jama.2015.18604.