Proportion of home deaths falls in South-West Scotland
Researchers based in South-West Scotland have studied the place of death of nearly 20,000 people in a bid to find out whether this pattern changed over time.
A team led by Dr Chris Isles, consultant in medicine at NHS Dumfries and Galloway and Emeritus Professor at the University of Glasgow, and Professor David Clark, based at the University of Glasgow’s Dumfries campus, found that fewer people died in their own home in 2010 than in 2000 in a study of 19,697 residents of Dumfries and Galloway.
“We show that in the decade to 2010, most deaths occurred in places other than home and also there was a steady fall in the proportion of home deaths – from 30% to 23%. The other major finding is that we can show that what a person dies from determines where they die: people with heart disease and cancer are most likely to die at home; people with stroke and dementia are very unlikely to do so,” said Dr Isles.
Between 2007 and 2010, men were more likely to die at home than women, while both sexes were less likely to die at home as they became older.
Older people with dementia as the cause of death were particularly unlikely to die in an acute hospital and very likely to die in a residential home.
Between 2007 and 2010, an increasing proportion of acute hospital deaths occurred in the specialist palliative care unit at Dumfries and Galloway Royal Infirmary.
Dr Isles said: “Lots of evidence tells us that home is the place that most people say they would like to die. However the proportion of people dying at home fell during our survey which means there is a mismatch between stated preference for place of death and where death actually occurs.”
The findings of this particular survey have significance beyond the Dumfries and Galloway area, Professor Clark explained.
“Death at home is often used as a marker of the quality of end-of-life care. Current policy emphasises that people should have a choice in the type of care they receive at the end of their lives. In some other countries - England and Canada – it looks as if the decline in home deaths has ‘bottomed out’ recently. It’s vital that we take the time now to find out more about patterns of death in Scotland to ensure we all get the end of life we would wish for our families, loved ones and for ourselves,” he said.
The results of this study should provide health and social care providers with a baseline to assess how their services are working for people at the end of their lives by using place of death as a quality marker, said Professor Clark.
“Patients and carers may also want to use the data to advocate for their wishes,” he added.
The Scottish Government made a commitment to encourage research in end-of-life care as part of its 2015 Strategic Framework for Action in Palliative and End of Life Care. The University of Glasgow End of Life Studies Group is working with other end-of-life experts to create a new palliative care research forum in Scotland.
Dr Isles said: “We now want to look at trends in the years since this survey to see if the fall in home deaths has stopped in our region. The study also needs to be replicated for the whole of Scotland and we are trying to make that happen.”
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First published: 9 February 2016