Dying at home: experience of the Verdun local community service centre.

OBJECTIVE: To demonstrate that it is possible for a team of palliative care nurses in an urban centre to care for more than 50% of their terminally ill patients at home until they die, and that medical care delivered in the home is a determining factor in death at home versus death in a hospital.
DESIGN: Analysis of place of death of terminally ill patients who died in 2012 and 2013 (N = 212) and who had been cared for by palliative care nurses, by type of medical care.
SETTING: The centre local de services communautaires (CLSC) in Verdun, Que, an urban neighbourhood in southwest Montreal. PARTICIPANTS: A total of 212 terminally ill patients. MAIN OUTCOME MEASURES: Rate of deaths at home.
RESULTS: Of the 212 patients cared for at home by palliative care nurses, 56.6% died at home; 62.6% received medical home care from CLSC physicians, compared with 5.0% who did not receive medical home care from any physician.
CONCLUSION: Combined with a straightforward restructuring of the nursing care delivered by CLSCs, development of medical services delivered in the home would enable the more than 50% of terminally ill patients in Quebec who are cared for by CLSCs to die at home--something that most of them wish for. Copyright© the College of Family Physicians of Canada.