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Which cancer patients die in nursing homes? Quality of life, medical and sociodemographic characteristics

Unit of Applied Clinical Research, NTNU, Trondheim and Unit of Oncology and Palliative Care, Department of Internal Medicine, Nordland Hospital, Bodø, Norway

Ingvild Saltvedt

Unit of Applied Clinical Research, NTNU and Section of Geriatrics, University Hospital of Trondheim, Trondheim, Norway

Peter Fayers

Unit of Applied Clinical Research, NTNU, Trondheim, Norway and Department of Public Health, Aberdeen Medical School, Aberdeen, UK

Jon HaKvard

Loge Unit of Applied Clinical Research, NTNU, Trondheim and Department of Behavioural Sciences in Medicine, University of Oslo, Norway

Marianne Ahlner-Elmqvist

Department of Oto-Rhino-Laryngology, Malmö University Hospital, Malmö, Sweden

Stein Kaasa

Unit of Applied Clinical Research, NTNU, Trondheim and Palliative Medicine Unit, Department of Radiotherapy and Oncology, University Hospital of Trondheim, Trondheim, Norway

In this study, cancer patientsflcharacteristics associated with death in nursing homes were explored. The study sample included 395 cancer patients who had participated in a trial of palliative care, 260 (66%) patients died in hospital, 80 (20%) at home and 55 (14%) in nursing homes. Health-related quality of life was prospectively recorded using the EORTC QLQ-C30 questionnaire. Death in nursing home was associated with greater age, not living with spouse and poor performance status. Patients dying in nursing homes reported severe functioning impairments and more fatigue and appetite loss compared with those dying elsewhere. The association between death in nursing homes and poor physical, role, cognitive and social functioning remained significant when sociodemographic and medical differences were taken into account. Further research on frail elderly cancer patients is warranted to improve their care, to evaluate the appropriateness of nursing home placement and for future planning of palliative care services.

Key Words: palliative care • place of death • nursing homes

Palliative Medicine, Vol. 17, No. 5, 433-444 (2003)
DOI: 10.1191/0269216303pm774oa


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