A prospective study of preferred versus actual place of death among patients referred to a palliative care home-care service.

In this first such study in an Irish setting, patients referred to a Hospice Home Care Team were asked where they would prefer to die, and were then followed until death to determine actual place of death, and factors that influenced same. Over 80% expressed a preference to die at home. Almost 50% of those who expressed a preference for a home death actually died there. Of those admitted to hospital or hospice to die, uncontrolled symptoms and inability of family to cope were the main reasons precipitating admission. On closer assessment, it was felt that a significant minority of those admitted could have been cared for at home had additional resources been available in the community. Facilitating choice in place of care for the dying is acknowledged government policy and, as such, greater resources should be made available to community health and social services to support ongoing care at home.