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Return home at the end of life: Patients' vulnerability and risk factors.
Vassal P., Le Coz P., Hervé C., Matillon Y., Chapuis F.
Palliative Medicine 25, 2 (2011) 139-47 - http://www.hal.inserm.fr/inserm-00612231
(21248182)
Return home at the end of life: Patients' vulnerability and risk factors.
Pascale Vassal1, 2, Pierre Le Coz3, Christian Hervé2, Yves Matillon4, François Chapuis5
1 :  Service de soins palliatifs
Hôpital Bellevue
Saint-Etienne
France
2 :  LEM - Laboratoire d'éthique médicale et médecine légale
Université Paris V - Paris Descartes
Faculté de médecine, 45 rue des Saints-Pères, Paris 75006
France
3 :  Espace éthique méditerranéen
AP-HM – Hôpital de la Timone
Marseille
France
4 :  EA4129 - Laboratoire Santé-Individu-Société
Hôpital de l'Hotel Dieu
Lyon
France
5 :  Unité de Méthodologie en Recherche Clinique
Hospices Civils de Lyon – Université Claude Bernard - Lyon I
Département d'Information Médicale, Lyon
France
Although most of the people in good health questioned about the subject said they would like to die at home, in the western world between 60 and 80% of deaths occur in hospital. Most authors consider that the indispensable conditions for a return home are the patient's desire and presence of the family and caregivers with the appropriate skills. The assessment of other factors predictive of a return home is inadequate. The aim of this study is to clarify how the return home is influenced by the vulnerability of the patient at the end of life, and by that of the family and caregivers. We carried out a multicentric, observational, prospective, exhaustive and longitudinal epidemiological study (three months follow-up), including 146 patients hospitalized at the end of their life and desiring to return home. For these patients the caregivers respected their freedom to choose to die at home in over half the cases (56%). Their overall vulnerability (personal, family context and caregivers) had a significant influence on the return home. This overall vulnerability was in fact identified as applying in 40% of the clinical situations, and made the possibility of a return home 50% less likely.
Sciences du Vivant/Ethique
Anglais
0269-2163

Articles dans des revues avec comité de lecture
10.1177/0269216310385876
Palliative Medicine (Palliat Med)
Publisher SAGE Publications (UK and US)
ISSN 0269-2163 (eISSN : 1477-030X)
internationale
03/2011
19/01/2011
25
2
139-47

Adolescent – Adult – Aged – 80 and over – Attitude to Death – Caregivers – Delivery of Health Care – Epidemiologic Methods – Family – Female – France – Home Care Services – Humans – Male – Middle Aged – Palliative Care – Patient Preference – Residence Characteristics – Risk Factors – Terminal Care – Terminally Ill – Vulnerable Populations

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