Japanese Study Indicates Death at Home Is Better for Terminally Ill Cancer Patients


Key Points

  • Patient quality of death and dying was higher at home vs palliative care units and hospitals, according to a Japanese study of terminally ill cancer patients.
  • Caregiver burden was lower for home vs hospital death.

In a Japanese study reported in the Journal of Clinical Oncology, Kinoshita et al found that death at home vs palliative care units or hospitals was better for terminally ill cancer patients and was not associated with an increased caregiver burden.

Study Details

The study included two bereavement surveys (67% response rate) conducted in October 2008 and October 2011 involving 2,247 family caregivers of cancer patients who died. Family members reported patient quality of death and dying and caregiver burden using the Good Death Inventory and Caregiving Consequences Inventory; responses were measured using 7-point Likert-type scales, with higher values indicating greater patient satisfaction and higher caregiver burden.

Patient Quality of Death and Dying

Patient quality of death and dying was significantly higher at home vs palliative care units and hospitals after adjustment for patient/family characteristics (adjusted means of 5.0 vs 4.6 and 4.3 (P < .001 for both comparisons). Home was superior to palliative care units and hospitals for domains of  “dying in a favorite place,” “good relationships with medical staff,” “good relationships with family,” and “maintaining hope and pleasure” (P < .001 for all comparisons).

Caregiver Burden

In an adjusted analysis, home death was associated with lower overall caregiver burden vs hospital death (adjusted means of 3.8 vs 4.0, P = .03). Financial burden was the only caregiver burden domain that differed significantly by place of death, with burden rated lower for death at home vs hospital (adjusted means of 3.2 vs 3.6, P = .02).

The investigators concluded: “Dying at home may contribute to achieving good death in terminally ill patients with cancer without causing remarkably increased caregiver burden. Place of death should be regarded as an essential goal in end-of-life care.”

Isseki Maeda, MD, PhD, of Osaka University Graduate School of Medicine, is the corresponding author of the Journal of Clinical Oncology article.

The study was supported by grants from the Ministry of Health, Labour, and Welfare of Japan. The study authors reported no potential conflicts of interest.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.