Dying at home better for cancer patients
For individuals with advanced cancer, dying at home rather than the hospital results in higher quality-of-life scores at the end of life.
New Delhi: For individuals with advanced cancer, dying at home rather than the hospital results in higher quality-of-life scores at the end of life, and may be easier on the patients` caregivers as well, according to a new research.
The study by researchers at Dana-Farber Cancer Institute found that cancer patients who die in the hospital or an intensive care unit have worse quality of life at the end-of-life, compared to patients who die at home with hospice services, and their caregivers are at higher risk for developing psychiatric illnesses during bereavement.
The striking finding of the study states that bereaved caregivers of patients who died in an intensive care unit (ICU) were five times more likely to be diagnosed with Posttraumatic Stress Disorder (PTSD), compared with caregivers of patients who died at home with hospice services.
"This is the first study to show that caregivers of patients who die in ICUs are at a heightened risk for developing PTSD," said the authors, led by Alexi Wright, a medical oncologist and outcomes researcher at Dana-Farber.
Patients and caregivers were interviewed at the beginning of the study and post death caregivers were interviewed on regular intervals.
After analyzing the data on 342 patient-caregiver pairs, the investigators found that patients who had died in the hospital or an ICU experienced more physical and emotional distress and worse quality of life than those dying at home.
Among the caregivers, they determined that 4 of 19 caregivers (21 percent) of patients dying in an ICU developed PTSD, compared with 6 of 137 (4.4 percent) when death occurred in the home/hospice setting.
"If patients are aware that more-aggressive care may affect not only their quality of life, but also their loved ones after their death, they may make different choices," said Wright.
The research has been published in the September issue of the Journal of Clinical Oncology.