Health Place. 2014 Feb 24;27C:77-83. doi: 10.1016/j.healthplace.2014.02.002. [Epub ahead of print]

The acute hospital setting as a place of death and final care: A qualitative study on perspectives of family physicians, nurses and family carers.

Reyniers T1, Houttekier D2, Cohen J3, Pasman HR4, Deliens L5.

Author information

• 1End-of-Life Care Research Group, Vrije Universiteit Brussel & Ghent University, Laarbeeklaan 103, 1090 Brussels (Jette), Belgium. Electronic address: thijs.reyniers@vub.ac.be.
• 2End-of-Life Care Research Group, Vrije Universiteit Brussel & Ghent University, Laarbeeklaan 103, 1090 Brussels (Jette), Belgium. Electronic address: dirk.houttekier@vub.ac.be.
• 3End-of-Life Care Research Group, Vrije Universiteit Brussel & Ghent University, Laarbeeklaan 103, 1090 Brussels (Jette), Belgium. Electronic address: joachim.cohen@vub.ac.be.
• 4Department of Public and Occupational Health, EMGO Institute for Health and Care Research and Expertise Center for Palliative Care, VU University Medical Center, Van der Boechorstraat 7, 1081 BT Amsterdam, The Netherlands. Electronic address: hrw.pasman@vumc.nl.
• 5End-of-Life Care Research Group, Vrije Universiteit Brussel & Ghent University, Laarbeeklaan 103, 1090 Brussels (Jette), Belgium; Department of Public and Occupational Health, EMGO Institute for Health and Care Research and Expertise Center for Palliative Care, VU University Medical Center, Van der Boechorstraat 7, 1081 BT Amsterdam, The Netherlands. Electronic address: luc.deliens@vub.ac.be.

Abstract

While the focus of end-of-life care research and policy has predominantly been on 'death in a homelike environment', little is known about perceptions of the acute hospital setting as a place of final care or death. Using a qualitative design and constant comparative analysis, the perspectives of family physicians, nurses and family carers were explored. Participants generally perceived the acute hospital setting to be inadequate for terminally ill patients, although they indicated that in some circumstances it might be a 'safe haven'. This implies that a higher quality of end-of-life care provision in the acute hospital setting needs to be ensured, preferably by improving communication skills. At the same time alternatives to the acute hospital setting need to be developed or expanded.