Preferences for place of death if faced with advanced cancer: a population survey in England, Flanders, Germany, Italy, the Netherlands, Portugal and Spain

B. Gomes, I.J. Higginson, N. Calanzani, J. Cohen, L. Deliens, B.A. Daveson, D. Bechinger-English, C. Bausewein, P.L. Ferreira, F. Toscani, A. Meñaca, M. Gysels, L. Ceulemans, S.T. Simon, H.R.W. Pasman, G. Albers, S. Hall, F.E.M. Murtagh, D.F. Haugen, J. DowningJ. Koffman, F. Pettenati, S. Finetti, B. Antunes, R Harding, R.H. On

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Background Cancer end-of-life care (EoLC) policies assume people want to die at home. We aimed to examine variations in preferences for place of death cross-nationally.

Methods A telephone survey of a random sample of individuals aged ≥16 in England, Flanders, Germany, Italy, the Netherlands, Portugal and Spain. We determined where people would prefer to die if they had a serious illness such as advanced cancer, facilitating circumstances, personal values and experiences of illness, death and dying.

Results Of 9344 participants, between 51% (95% CI: 48% to 54%) in Portugal and 84% (95% CI: 82% to 86%) in the Netherlands would prefer to die at home. Cross-national analysis found there to be an influence of circumstances and values but not of experiences of illness, death and dying. Four factors were associated with a preference for home death in more than one country: younger age up to 70+ (Germany, the Netherlands, Portugal, Spain), increased importance of dying in the preferred place (England, Germany, Portugal, Spain), prioritizing keeping a positive attitude (Germany, Spain) and wanting to involve family in decisions if incapable (Flanders, Portugal).

Conclusions At least two-thirds of people prefer a home death in all but one country studied. The strong association with personal values suggests keeping home care at the heart of cancer EoLC.
Original languageEnglish
Pages (from-to)2006-2015
JournalAnnals of Oncology
Issue number8
Publication statusPublished - 2012

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