Palliative and end-of-life care in a small Caribbean country : a mortality follow-back study of home deaths

Article indépendant

JENNINGS, Nicholas | CHAMBAERE, Kenneth | CHAMELY, Stacey | MACPHERSON, Cheryl C. | DELIENS, Luc | COHEN, Joachim

CONTEXT: Empirical information on circumstances of dying from advanced illness in developing countries remains sparse. Evidence indicates that out-of-hospital end-of-life care can have significant benefits such as increased satisfaction for the patient and caregivers and cost-effective for a health-care system. Services that are aimed to deliver care at private homes may be a good model for low- and middle-income countries or other low-resourced settings. OBJECTIVES: To examine specialized, generalist, and informal palliative care provision and to describe the end-of-life care goals and treatments received. METHOD: A mortality follow-back study with data obtained from general practitioners certifying a random sample of death certificates of adult decedents who died between March and August 2018. The questionnaire inquired about the characteristics of care and treatment preceding death. RESULTS: Three hundred nine questionnaires were mailed, and the response rate was 31% (N = 96), of which 76% were nonsudden deaths. Of these cases, 27.4% received no palliative care, 39.7% received it from a general practitioner, and 6.8% from a specialized palliative care service. Comfort maximization (60.3%) was the main goal of care in the last week of life, and analgesics (53.4%) were the predominant treatment for achieving this goal. In addition, 60.3% received informal palliative care from a family member. CONCLUSION: The largest part of end-of-life care at home in Trinidad and Tobago is provided by family members, whereas professional caregivers feature less prominently. To ensure quality in end-of-life care, better access to analgesics is needed, and adequate support and education for family members as well as general practitioners are highly recommended.

http://dx.doi.org/10.1016/j.jpainsymman.2020.06.029

Voir la revue «JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 60»

Autres numéros de la revue «JOURNAL OF PAIN AND SYMPTOM MANAGEMENT»

• Description
• Sujet/Public
• Outil
• Outil d'anticipation
• Gestion