Thousands of cancer patients denied wish to die at home

Numbers of community or district nurses nurses are dropping, a shortage worsening end-of-life care, says the RCN.

Tens of thousands of people with cancer are dying in hospital every year even though they would rather spend their final days at home or in a hospice.

Although only 1% of cancer patients say they would prefer to die in hospital, 38% do, according to research by Macmillan Cancer Support, equating to 62,000 people a year across the UK.

A lack of health services outside hospitals, such as district nurses, to support people in their homes in their last days has been cited as a key reason behind the discovery.

But Macmillan said “a crisis of communication in the UK when it comes to death” and especially cancer patients’ reluctance to talk about their feelings, including their death, was preventing people achieving their own preferences. .

“There is a stark difference between a ‘good’ and a ‘bad’ death. We want everyone, where possible, to have a death that’s pain-free and in the place of their choosing. This is where the power of talking about death in advance is crucial,” said Adrienne Betteley, the charity’s head of health and social care.

Macmillan’s research, among 2,005 people who had been diagnosed with cancer, revealed that three in four had thought about the fact that they might die from the disease and one in five thought about it constantly or often.

However, 35% of those questioned had not spoken to anyone else about how they were feeling and just 8% had discussed matters with any of their health professionals.

Macmillan suggests people with cancer more readily relay how they are feeling, especially about where they want to die.

“The only certainty in life is that we will all die. What is less certain is where and what experience we will have when it happens. It’s only by talking about dying that we can agree what is really important to us, and put plans in place to make that happen,” said Lynda Thomas, Macmillan’s chief executive.

Amanda Cheesley, the Royal College of Nursing’s professional lead for long-term conditions and end-of-life care, said: “This country sadly still has serious work to do when it comes to end-of-life care. We must help patients to express their wishes, but we also need to make more options available in the first place. Declining numbers of community and district nurses and a lack of social care mean too many have to stay in hospital whether they want to or not.

“The nursing shortage is making a bad situation worse. With fewer nursing staff on wards, many are unable to facilitate discussions about death, and two-thirds of nurses say they don’t have the time to deliver the high-quality care that dying patients need.”


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