25 Family caregiver socio-economic status, access to palliative care and patients’ place of death: a health survey for england study

M Johnson; V Allgar; H Chen; L Dunn; U Macleod; D Currow

doi:10.1136/bmjspcare-2017-001407.25

25 Family caregiver socio-economic status, access to palliative care and patients’ place of death: a health survey for england study

M Johnson, V Allgar, H Chen, L Dunn, U Macleod, D Currow

Peninsula Medical School

Research output: Contribution to journal › Article › peer-review

Abstract

BackgroundThe personal impact is considerable for family caregivers at the end-of-life.AimsTo i) describe family caregivers at the end-of-life, ii) those willing to repeat this role under similar circumstances; iii) investigate associations between caregivers’ household income, patients’ access to palliative care services (PCS) and place of patients’ death.MethodsEnd-of-life caregiver questions in the Health Survey for England: had someone close to them died of a terminal illness within past 5 years?; intensity of care?; PCS accessed?; place of death?; willingness to care again?. Associations were explored using univariable analyses and multiple logistic regression.Results2167/8861 (25%) respondents had someone close die; 645/8861 (7.3%) provided personal care (caregivers). Younger caregiver age (≤65; OR 2.79; 95% CI 1.36, 5.74) and use of PCS (OR: 1.95, 95% CI: 1.09, 3.48) were associated with willingness to caregive again. 55% of decedents accessed PCS. PCS access reduced hospital (p<0.001), and increased home (p<0.001) deaths. Overall, respondents’ income (adjusted for PCS) was unrelated to decedents’ place of death but those with the most affluentcaregiverswereleastlikely to die at home (p=0.069).ConclusionsMost who have provided end-of-life care for someone close would be willing to provide care again; more likely for younger caregivers and when PCS was accessed.PCS access was associated with fewer hospital deaths and more home deaths. Decedents with more affluentcaregiverswere theleastlikely to die at home. Such caregivers are likely to be powerful patient advocates; ensuring correct understanding of goals of care is important.

Original language	English
Pages (from-to)	A356.2-A356
Number of pages	0
Journal	BMJ Supportive & Palliative Care
Volume	7
Issue number	3
DOIs	https://doi.org/10.1136/bmjspcare-2017-001407.25
Publication status	Published - Sept 2017

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title = "25 Family caregiver socio-economic status, access to palliative care and patients{\textquoteright} place of death: a health survey for england study",

abstract = "BackgroundThe personal impact is considerable for family caregivers at the end-of-life.AimsTo i) describe family caregivers at the end-of-life, ii) those willing to repeat this role under similar circumstances; iii) investigate associations between caregivers{\textquoteright} household income, patients{\textquoteright} access to palliative care services (PCS) and place of patients{\textquoteright} death.MethodsEnd-of-life caregiver questions in the Health Survey for England: had someone close to them died of a terminal illness within past 5 years?; intensity of care?; PCS accessed?; place of death?; willingness to care again?. Associations were explored using univariable analyses and multiple logistic regression.Results2167/8861 (25%) respondents had someone close die; 645/8861 (7.3%) provided personal care (caregivers). Younger caregiver age (≤65; OR 2.79; 95% CI 1.36, 5.74) and use of PCS (OR: 1.95, 95% CI: 1.09, 3.48) were associated with willingness to caregive again. 55% of decedents accessed PCS. PCS access reduced hospital (p<0.001), and increased home (p<0.001) deaths. Overall, respondents{\textquoteright} income (adjusted for PCS) was unrelated to decedents{\textquoteright} place of death but those with the most affluentcaregiverswereleastlikely to die at home (p=0.069).ConclusionsMost who have provided end-of-life care for someone close would be willing to provide care again; more likely for younger caregivers and when PCS was accessed.PCS access was associated with fewer hospital deaths and more home deaths. Decedents with more affluentcaregiverswere theleastlikely to die at home. Such caregivers are likely to be powerful patient advocates; ensuring correct understanding of goals of care is important.",

author = "M Johnson and V Allgar and H Chen and L Dunn and U Macleod and D Currow",

year = "2017",

month = sep,

doi = "10.1136/bmjspcare-2017-001407.25",

language = "English",

volume = "7",

pages = "A356.2--A356",

journal = "BMJ Supportive & Palliative Care",

issn = "2045-435X",

number = "3",

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T1 - 25 Family caregiver socio-economic status, access to palliative care and patients’ place of death: a health survey for england study

AU - Johnson, M

AU - Allgar, V

AU - Chen, H

AU - Dunn, L

AU - Macleod, U

AU - Currow, D

PY - 2017/9

Y1 - 2017/9

N2 - BackgroundThe personal impact is considerable for family caregivers at the end-of-life.AimsTo i) describe family caregivers at the end-of-life, ii) those willing to repeat this role under similar circumstances; iii) investigate associations between caregivers’ household income, patients’ access to palliative care services (PCS) and place of patients’ death.MethodsEnd-of-life caregiver questions in the Health Survey for England: had someone close to them died of a terminal illness within past 5 years?; intensity of care?; PCS accessed?; place of death?; willingness to care again?. Associations were explored using univariable analyses and multiple logistic regression.Results2167/8861 (25%) respondents had someone close die; 645/8861 (7.3%) provided personal care (caregivers). Younger caregiver age (≤65; OR 2.79; 95% CI 1.36, 5.74) and use of PCS (OR: 1.95, 95% CI: 1.09, 3.48) were associated with willingness to caregive again. 55% of decedents accessed PCS. PCS access reduced hospital (p<0.001), and increased home (p<0.001) deaths. Overall, respondents’ income (adjusted for PCS) was unrelated to decedents’ place of death but those with the most affluentcaregiverswereleastlikely to die at home (p=0.069).ConclusionsMost who have provided end-of-life care for someone close would be willing to provide care again; more likely for younger caregivers and when PCS was accessed.PCS access was associated with fewer hospital deaths and more home deaths. Decedents with more affluentcaregiverswere theleastlikely to die at home. Such caregivers are likely to be powerful patient advocates; ensuring correct understanding of goals of care is important.

AB - BackgroundThe personal impact is considerable for family caregivers at the end-of-life.AimsTo i) describe family caregivers at the end-of-life, ii) those willing to repeat this role under similar circumstances; iii) investigate associations between caregivers’ household income, patients’ access to palliative care services (PCS) and place of patients’ death.MethodsEnd-of-life caregiver questions in the Health Survey for England: had someone close to them died of a terminal illness within past 5 years?; intensity of care?; PCS accessed?; place of death?; willingness to care again?. Associations were explored using univariable analyses and multiple logistic regression.Results2167/8861 (25%) respondents had someone close die; 645/8861 (7.3%) provided personal care (caregivers). Younger caregiver age (≤65; OR 2.79; 95% CI 1.36, 5.74) and use of PCS (OR: 1.95, 95% CI: 1.09, 3.48) were associated with willingness to caregive again. 55% of decedents accessed PCS. PCS access reduced hospital (p<0.001), and increased home (p<0.001) deaths. Overall, respondents’ income (adjusted for PCS) was unrelated to decedents’ place of death but those with the most affluentcaregiverswereleastlikely to die at home (p=0.069).ConclusionsMost who have provided end-of-life care for someone close would be willing to provide care again; more likely for younger caregivers and when PCS was accessed.PCS access was associated with fewer hospital deaths and more home deaths. Decedents with more affluentcaregiverswere theleastlikely to die at home. Such caregivers are likely to be powerful patient advocates; ensuring correct understanding of goals of care is important.

U2 - 10.1136/bmjspcare-2017-001407.25

DO - 10.1136/bmjspcare-2017-001407.25

M3 - Article

SN - 2045-435X

VL - 7

SP - A356.2-A356

JO - BMJ Supportive & Palliative Care

JF - BMJ Supportive & Palliative Care

IS - 3

ER -

25 Family caregiver socio-economic status, access to palliative care and patients’ place of death: a health survey for england study

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