A comparison between end-of-life home care clients with cancer and heart failure in Ontario

Home Health Care Serv Q. 2015;34(1):14-29. doi: 10.1080/01621424.2014.995257.


Individuals with heart failure experience complex symptoms and have a poor prognosis, comparable to those with cancer. However, people with heart failure are less likely to be recognized as needing palliative care. We compared seriously ill home care clients with cancer versus those with heart failure to explore differences between them using existing data from the Resident Assessment Instrument for Home Care (RAI-HC). The sample included 1,475 older adults (65+) in Ontario who had a prognosis of less than 6 months or severe health instability. Clients with heart failure were significantly older (p < .0001) and experienced significantly higher rates of impairment in activities of daily living (p = .005), cognitive impairment (p < .0001), and severe health instability (p < .0001), but were significantly less likely to have a prognosis of less than 6 months (p < .0001). Home care clients with heart failure have needs similar to those with cancer yet are typically not identified as having a terminal prognosis.

Keywords: Resident Assessment Instrument for Home Care; cancer; end-of-life care; heart failure; palliative care.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Heart Failure / epidemiology
  • Heart Failure / nursing*
  • Humans
  • Male
  • Neoplasms / epidemiology
  • Neoplasms / nursing*
  • Ontario
  • Palliative Care*
  • Patient Acuity
  • Terminal Care*