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Social and clinical determinants of preferences and their achievement at the end of life: prospective cohort study of older adults receiving palliative care in three countries.

Authors
  • Higginson, Irene J1
  • Daveson, Barbara A2
  • Morrison, R Sean3
  • Yi, Deokhee4
  • Meier, Diane3
  • Smith, Melinda2
  • Ryan, Karen5
  • McQuillan, Regina6
  • Johnston, Bridget M7
  • Normand, Charles7
  • 1 Cicely Saunders Institute Of Palliative Care, Policy & Rehabilitation, King's College London, and King's College Hospital, Bessemer Road, London, SE5 9PJ, UK. [email protected]
  • 2 Cicely Saunders Institute Of Palliative Care, Policy & Rehabilitation, King's College London, and King's College Hospital, Bessemer Road, London, SE5 9PJ, UK.
  • 3 Department of Geriatrics and Palliative Medicine, Mount Sinai School of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029-6574, USA.
  • 4 Cicely Saunders Institute Of Palliative Care, Policy & Rehabilitation, King's College London, and King's College Hospital, Bessemer Road, London, SE5 9PJ, UK. [email protected]
  • 5 Mater Misericordiae Hospital, Eccles Street, Dublin 7, Ireland. , (Ireland)
  • 6 Beaumont Hospital, Beaumont Road, Dublin 9, Ireland. , (Ireland)
  • 7 The Centre of Health Policy and Management, Trinity College Dublin, Room 0.21, 3-4 Foster Place, College Green, Dublin 2, Ireland. , (Ireland)
Type
Published Article
Journal
BMC geriatrics
Publication Date
Nov 23, 2017
Volume
17
Issue
1
Pages
271–271
Identifiers
DOI: 10.1186/s12877-017-0648-4
PMID: 29169346
Source
Medline
Keywords
License
Unknown

Abstract

Although home is the most common first preference, it is polarising and for 16% it is the least preferred. Inpatient palliative care unit emerges as the second most preferred place, is rarely least preferred, and yet was often not achieved for those who wanted to die there. Factors affecting stated preferences and met preferences differ. Available services, notably community support and palliative care units, require expansion. Contrasting actual place of death with capacity for meeting patient and family needs may be a better quality indicator than simply 'achieved preferences'.

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