Dying now

Lancet. 1984 Apr 28;1(8383):950-2. doi: 10.1016/s0140-6736(84)92400-0.

Abstract

In a random sample of 262 deaths, 21% of the patients lived alone and a quarter of the caring relatives were over 70 years old. The difficulties of the relatives were more often a cause for hospital admission than those of the patients. Health professionals and relatives differed considerably in their assessment of the same case. 24% of relatives were especially grateful to their general practitioners but 37% were critical. The uncaring attitude of the hospitals was criticised by 27% of the relatives, although hospital nurses were the most praised of all professionals. Symptom control was of variable quality. The community nurse categorised the quality of life in the final illness as poor or very poor in 44% of cases.

KIE: An assessment of terminal care in hospital and home settings in the United Kingdom is achieved through an investigation of a sample of 262 deaths, excluding hospice cases. Physical and emotional problems of relatives caring for patients are reported to a greater extent than patient distress; thus, it is noted that patient-centered medicine is unlikely to provide adequate support for relatives. Community nurses report that the quality of terminal life is poor in nearly half of the cases. Relatives criticize doctors for poor symptom control, difficulty in securing information, and pointless overtreatment, and censure hospitals for an uncaring attitude. However, a substantial percentage express special gratitude to doctors and hospitals, with hospital nurses receiving the most praise.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anxiety / psychology
  • Disclosure
  • Family Characteristics
  • Home Care Services
  • Home Nursing / standards
  • Hospitalization
  • Humans
  • Middle Aged
  • Nurse-Patient Relations
  • Physician-Patient Relations
  • Quality of Life
  • Retrospective Studies
  • Terminal Care / standards*
  • United Kingdom