Effectiveness of home-based end-of-life care
Commentary on: Shepperd S, Gonçalves-Bradley DC, Straus SE, Wee B. Hospital at home: home-based end-of-life care. Cochrane Database of Systematic Reviews. 2021;Issue 3. 10.1002/14651858.CD009231.pub3
When a person has been diagnosed with a terminal illness and has less than 6 months to live, and curative treatments are no longer effective, end-of-life care or hospice care may be initiated. Studies suggest that approximately 7 million people a year are given this type of care, which strives to reduce distress and improve quality of life for patients and their families by providing comprehensive physical, psychosocial, and spiritual support. Surveys show that most individuals would prefer to receive this care at home when given the option. However, there are still some uncertainties regarding the effects of end-of-life care at home on a range of important patient outcomes. As a result, a Cochrane review was conducted/updated to study the effects of receiving end-of-life care at home, looking at these outcomes. The aim of this commentary is to critically appraise this Cochrane review and expand upon the findings of the review in context to practice.
When a person has been diagnosed with a terminal illness and has less than 6 months to live, with curative treatments no longer being viable, end-of-life care or hospice care is initiated (Huffman and Harmer, 2022). It is estimated that approximately 7 million people per year receive this type of care (Connor et al, 2021). The aim of this care is to reduce distress and improve the quality of life (QoL) for patients and their families by providing comprehensive support with physical, psychosocial, and spiritual needs of the individual (Rome et al, 2011). Survey data suggest that, when given the choice, most individuals prefer to receive end-of-life care at home (Arnold et al, 2015; Higginson et al, 2017; Ali et al, 2019). However, even when end-of-life care is provided, there are still uncertainties regarding the effect on the risk of likelihood of dying in hospital, and what effect providing this service has on patients' symptoms and QoL (Shepperd et al, 2021). Subsequently a Cochrane review was conducted/updated to assess the effects of receiving end-of-life care at home on these outcomes (Shepperd et al, 2021).
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