Hospital or Home? Where Should Children Die and How Do We Make that a Reality?

Title

Hospital or Home? Where Should Children Die and How Do We Make that a Reality?

Creator

Johnston E E; Martinez I; Currie E; Brock K E; Wolfe J

Publisher

Journal of Pain and Symptom Management

Date

2019

Subject

End-of-life care; Home death; Location of death; Pediatrics; Seriously ill children

Description

CONTEXT: Most of the 20,000 US children dying of serious illnesses annually die in the hospital. It is unknown if this hospital death predominance reflects family wishes or systemic issues such as lack of hospice access. Hence, we need to better understand location of death preferences for children and their families. OBJECTIVE: To better understand location of death preferences in North America, we reviewed the literature to examine the evidence for and against home death in seriously ill children (0-18years). METHODS: We searched English articles in PubMed, PsycINFO, and Embase published 2000-2018 for articles related to parental, child/adolescent, and provider preference for death location and articles that correlated death location with bereavement or quality of life outcomes. RESULTS: The search results (n=877 articles and n=58 abstracts of interest) were reviewed and 34 relevant articles were identified. Parent, child, and provider preferences, bereavement outcomes, and associated factors all point to some preference for home death. These findings should be interpreted with several caveats: 1) Many studies are small and prone to selection bias, 2) Not all families prefer home death and some that do are not able to achieve home death due to inadequate home support, 3) Studies of bereavement outcomes are lacking. CONCLUSION: Adequate resources are needed to ensure children can die in their chosen location - be that home, hospital, or free-standing hospice. This review highlights research areas needed to better understand death location preference and programs and policies that will support home death for those that desire it.

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Citation List Month

February 2020 List

Collection

Citation

Johnston E E; Martinez I; Currie E; Brock K E; Wolfe J, “Hospital or Home? Where Should Children Die and How Do We Make that a Reality?,” Pediatric Palliative Care Library, accessed August 4, 2021, https://pedpalascnetlibrary.omeka.net/items/show/16896.

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