Preference of place for end-of-life cancer care and death among bereaved Japanese families who experienced home hospice care and death of a loved one

Purpose The aim of this study was to clarify factors related to the preference of place for end-of-life cancer care and death, from the perspective of the bereaved family. Methods In June 2007, in Japan, a cross-sectional anonymous questionnaire, which included a well-validated scale of component factors of hospice outcome, was administered to the bereaved family members (N=294) of cancer patients who had died at home at least 6 months ago. Participants were recruited from 14 home hospices across the nation. We asked the preference of place for end-of-life care and death. Results Fifty-eight percent of participants preferred home settings for end-of-life care and 68% preferred to die at home. Multivariate logistic regression identified: (1) males, participant who had other caregivers, a higher-good death concept, and those who experienced mastery as a consequence of caregiving were more likely to prefer home for end-of-life cancer care and (2) males, participant who had other caregivers, and experienced reprioritization as a consequence of caregiving and those who were enrolled in home hospice services for more than 60 days were more likely to prefer to die at home. Conclusions Home hospice services need to be developed in Japan so that family support programs can be initiated early enough to support the family burden of household maintenance and caring for the patient. Quality improvement of home hospice services will support patients and families through end-of-life care and facilitate a good death at home.