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In order to ensure haematology patients receive appropriate end-of-life care, and are enabled to die in their preferred place, it is crucial that an evidence base is established so that existing practices can be defined and evaluated.
It has recently been suggested, for example, that if more cancer patients were enabled to die at home, the UK National Health Service could make savings of £100 m every year (Burke, 2004).
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While most people faced with a terminal illness would prefer to die at home, less than a third in England are enabled to do so with many dying in National Health Service hospitals.
While most people faced with a terminal illness would prefer to die at home [ 1, 2], less than a third in England are enabled to do so with many dying in National Health Service (NHS) hospitals [ 2, 3].
One of the aims of the NEoLCP was to enable people to die in their preferred place, where possible.
The Dutch government has chosen a policy of strengthening palliative care in order to enable patients to die at home according to their preference.
One way of improving the dying experience, as illustrated by the statements of the WHO [ 3], is to enable people to die at home under the care of their general practitioner (GP), as many would prefer [ 4, 5].
(district nurse 6, practice D) The constraints to enabling patients to die at their preferred place relate to contingent factors or wider issues (for example, family capacity or service availability).
Further information relating to the factors associated with hospital death will promote understanding and highlight 'at-risk' groups of patients who may benefit from early interventions to enable them to die in their preferred place, where possible.
Existing evidence suggests that informal support networks may help to naturalise' dying; offer better support to the person and family; reduce isolation; target professional support more effectively and equitably; and enable choice to die at home [ 7].
One of the objectives of palliative care is enabling patients to die where they prefer [ 5] and 'place of death' has been proposed as a quality indicator of palliative care [ 6].
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com