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Logo of jroyalcgpracBJGP at RCGPBJGP at PubMed CentralJ R Coll Gen Pract at PubMed CentralRCGP homepage
J R Coll Gen Pract. 1978 January; 28(186): 19-22, 25-28, 30.
PMCID: PMC2158689

Home or hospital? Terminal care as seen by surviving spouses


Among 276 married patients with cancer under the age of 65 who died in two South London boroughs during the period 1967 to 1971, 41 were still under active treatment at the time of death. I studied the remaining 85 per cent who experienced some form of terminal care, and in particular compared reports by the surviving spouses of 65 patients whose care was home-centred and 100 hospital-centred patients.

Although home-centred care was most often chosen for patients who were said to have had little severe pain before the period of terminal care, during that period there was a sharp increase in reports of pain, much of it severe and unrelieved. Hospital-centred patients were said to have had much less pain and more confusion during the final phase of care and were more likely to have been confined to bed than those at home. The amount of anxiety reported by the patient's spouse was not markedly different under the two patterns of care, nor did the pattern of care influence subsequent adjustment to bereavement.

Qualitative differences between the two groups are considered and it is concluded that although home-centred care can be successful it is often associated with unnecessary suffering. Implications for the home care of the terminally ill are discussed.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Parkes CM, Brown RJ. Health after bereavement. A controlled study of young Boston widows and widowers. Psychosom Med. 1972 Sep-Oct;34(5):449–461. [PubMed]
  • Twycross RG. The use of narcotic analgesics in terminal illness. J Med Ethics. 1975 Apr;1(1):10–17. [PMC free article] [PubMed]

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