‘Sitting service’ at end of life may improve chances of dying at home

By Sarah Guy, medwireNews Reporter

Individuals at the end of their life who use a sitting service to avoid being alone while dying or to give respite to family members who are caring for them, are significantly more likely to die at home than those who do not use such a service, report researchers.

The results are from a small Swedish study conducted in a municipality that has a focus on providing palliative care to all those at the end of life, regardless of age, domicile, diagnosis, and place of care.

"The overall goal for persons in the final stage of life is to maintain as good a quality of life as possible," say Birgitta Wallerstedt (Örebro University) and colleagues in the Scandinavian Journal of Caring Sciences. "Still, the regular home is for many people the most preferred place of care and death," they add.

The sitting service used by participants of the current study was provided by nurses educated in palliative care who offered around-the-clock care at home, or in a palliative care unit or nursing home, and included care of the dying person as well as help with caregiving and support for the family.

A total of 174 palliative care patients were included in the analysis, most of whom were older than 65 years (mean age 83 years), women (60%), had a noncancer diagnosis (58%), and lived in nursing homes (51%).

Sitting services were used by 28 (16%) people, note Wallerstedt et al, with two-thirds living at home. The sitting service group was younger on average (more users were under 84 years than over), and their time in the palliative phase of life was shorter compared with those who did not use the service, at a mean 31 versus 55 days.

While the most common place of death was in a nursing home, at 63%, with an overall rate of dying at home of 12%, sitting services significantly affected the possibility of dying at home, report the researchers. Specifically, 32% of those who used the service died at home compared with just 8% of those who did not.

One finding that the researchers draw particular attention to is that physicians in the community identified older persons as well as persons with various kinds of incurable disease as being in a palliative phase.

It highlights an awareness that the palliative care concept should not only apply to those with a cancer diagnosis, they conclude.

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