Access to respite services for caregivers increases the probability of dying at home by 2.7 times, according to an evaluative study by McGill University researcher Kelley Kilpatrick and her team. Titled “Factors that support home deaths for patients receiving at-home palliative and end-of-life care: a sequential mixed-methods explanatory study”, the paper was published in BMC Palliative Care.
Funded by the Quebec Ministry of Health and Social Services (MSSS) as part of its 2020-2025 Action Plan for equitable access to quality palliative and end-of-life care (PEoLC), the study examines the factors that best support patients who wish to die at home as well as their caregivers.
The study in a nutshell
Researchers analyzed over 5,900 administrative files (2015 to 2024) and conducted 73 semi-structured interviews with patients receiving hospice PEoLC, caregivers, service providers, and decision-makers. The patients were almost evenly split between women and men, and their average age was 78. Just over 25% lived alone. Close to 30% died at home.
Factors that make it possible to die at home
The interviews with patients and caregivers revealed the importance of good communication and timely intervention. In describing the support of nurse practitioners, one caregiver said, “She even gave us her cell phone number, I could text her and she’d get back to us within five minutes…Whenever there was a problem, she was there to help us navigate the medical system. And it’s… it’s not simple.”
Fundamental needs of people requiring at-home palliative care include honouring their wishes and providing timely access to compassionate essential services such as nursing care, hygiene care, and palliative support.
The researchers concluded that the Health Ministry can achieve its goal of providing equitable access to quality palliative and end-of-life care throughout Quebec by:
- Investing in respite services for caregivers
- Strengthening the stability of homecare teams
- Standardizing at-home palliative care services across the CLSC network
- Fully mobilizing specialized nurse practitioners to provide symptom and pain management
Although the study was conducted in a high-income country, Kilpatrick believes its conclusions are applicable to other parts of the world. “An at-home PEoLC approach which addresses the physical, psychological, spiritual and social needs of patients receiving PEoLC and their caregivers enables patients to remain at home longer and to die at home when that is their wish.”
Kelley Kilpatrick is Assistant Professor and Susan E. French Chair in Nursing Research and Innovative Practice at McGill University’s Ingram School of Nursing, and a researcher at the Centre de recherche de l'Hôpital Maisonneuve-Rosemont, part of the CIUSSS de l'Est-de-l'Île-de-Montréal.
Read the study: https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-025-01840-0