The changing needs of end of life care

9 August 2019

CBEH Director Professor Stephen Birch and colleagues have published new research that investigates the needs of patients and the services they receive in the final year of life. Most people develop care needs in the final years of their life, and these needs typically change over time. This scoping study of peer-reviewed published open access and print research literature sought to focus on two main questions: 

  1. What are the frequency and types of EOL care setting transitions or moves preceding death?

  2. Why did these EOL care setting transitions or moves occur?

Do transitions reflect the ideals of palliative care?

As their health deteriorates, moves between care settings may be required but this review of the literature shows cases where care setting transitions may have little to do with end-of-life care needs. Instead, they reflect the needs, demands, availability, or funding provisions of the country or funding body and organizations providing care. 

There are also considerable knowledge gaps in current research. Much of the current research focuses on the transition into hospitals, and little insight is obtained on other palliative care options. 

Conclusions from the report   

This review demonstrates the need to quantify and justify end-of-life care setting transitions as it appears dying people are frequently moved, often as death nears. This research is needed to distinguish transitions related to end-of-life care needs and those arising from pressures on or from care providers and others unrelated to the person’s care needs.

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Professor Stephen Birch

Professor Stephen Birch