Challenges to end of life care in the acute hospital setting

Carole Willard, Karen Luker

    Research output: Contribution to journalArticlepeer-review


    Background: Research exploring patients' care and treatment preferences at the end of life (EOL) suggests they prefer comfort more than life-extension, wish to participate in decision-making, and wish to die at home. Despite these preferences, the place of death for many patients is the acute hospital, where EOL interventions are reported to be inappropriately invasive and aggressive. Aim: This paper discusses the challenges to appropriate EOL care in acute hospitals in the UK, highlighting how this setting contributes to the patients' and families' care and treatment requirements being excluded from decision-making. Methods: Twenty-nine cancer nurse specialists from five hospitals participated in a grounded theory study, using observation and semi-structured interviews. Data were collected and analysed concurrently using the constant comparative method. Results: EOL interventions in the acute setting were driven by a preoccupation with treatment, routine practice and negative perceptions of palliative care. All these factors shaped clinical decision-making and prevented patients and their families from fully participating in clinical decision-making at the EOL. © 2006 SAGE Publications.
    Original languageEnglish
    Pages (from-to)611-615
    Number of pages4
    JournalPalliative Medicine
    Issue number6
    Publication statusPublished - 2006


    • Decision-making
    • End of life
    • Qualitative research


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