Is effective, person-centred, home-based palliative care truly achievable?

摘要

When we say that most people express a desire to die in their own homes, what do we really mean? Have we really explored and elucidated what this means and can we promise the appropriate resources, skilled practitioners and support to enable this to happen? Palliative care at home has been a topic of interest for practitioners, researchers and, patients as well as families for some time; yet, the issue is often over-simplified in terms of choice, place of death and preferences for place of care. Indeed, it is standard practice in the United Kingdom for patients to be asked about their choice regarding place of care and place of death on admission to palliative care services, without necessarily exploring the issue further. Is this a considered person-centred issue or a tick-box exercise? Health policy around the world and in the United Kingdom, in particular, see home as a panacea in terms of a place to die and attempts made to enable a shift from acute-based care to a community-focussed care, and in turn enable more people to be cared for and to die at home.