Bereaved Carers Need Support at Home in the Last 90 Days of Life: A Cross-Sectional Survey With Subgroup Analysis

Abstract

This study investigates bereaved carers' experiences with end-of-life care and the factors associated with increased emergency department presentation, hospital admission and rates of hospital death in the last 90 days of life. Bereaved carers completed a modified Views of Informal Carers - Evaluation of Services - Short Form, and their responses were linked to the medical records of the decedents. The survey was sent to 1,546 people, and 246 surveys were returned (response rate 15.9%). 102 survey respondents reported their decedent had a known preference around place of death. 70/102 (68.6%) wished to die at home, but 187/246 (76.3%) died in hospital. Nevertheless, 200/243 (82.3%) of carers felt that the person died in the right place. Frequent attendance at emergency department was associated with bereaved carers feeling unsupported at home (χ2 = 8.74, p < 0.05), and with higher rates of hospital death (χ2 = 12.44, p < 0.05). Adequate help and support for carers at home is essential to reduce frequent emergency department attendance in the final months of life.