A new approach for the management of patients with terminal illness is to provide home-based care that focuses on relief of pain and other symptoms while attending to a person’s emotional and spiritual needs.
However, physicians are often reluctant to have a patient leave the hospital because they are fearful that less medical care would be available and life may be shortened.
Now, a large study from Japan reveals that cancer patients who died at home tended to live longer than those who died in hospitals. The findings suggest that oncologists should not hesitate to refer patients for home-based palliative care simply because less medical treatment may be provided.
Researchers explain that while most people say that they would prefer to be cared for at home if they were dying, it has been unclear if the care they receive there would be as good as the care delivered at a hospital.
Jun Hamano, M.D., of the University of Tsukuba in Japan, and his colleagues looked at the issue by prospectively studying 2069 patients, comprising 1582 patients receiving hospital-based palliative care and 487 receiving home-based palliative care.
Investigators were surprised to find that life was prolonged when a patient received care at their home.
Specifically, the investigators found that the survival of patients who died at home was significantly longer than that of patients who died in hospitals. This finding held true even after adjusting for patients’ demographic and clinical characteristics, as well as other factors.
Researchers say that although it is natural that a cancer patient and family tend to be concerned that the quality of medical treatment provided at home will be inferior to that given in a hospital and that survival might be shortened, the opposite was found true.
“That home death does not actually have a negative influence on the survival of cancer patients at all, and rather may have a positive influence, could suggest that the patient and family can choose the place of death in terms of their preference and values,” said Hamano.
“Patients, families, and clinicians should be reassured that good home hospice care does not shorten patient life, and even may achieve longer survival.”