Dying well at home: the case for integrated working

About this guide

This guide is based on evidence about what is needed to offer good care to people who are approaching the end of life and wish to be cared for and die in their own homes. It does not cover residents who live in care homes.

The guide is based on:

• a review of available quantitative and qualitative published research evidence, including studies that systematically collect qualitative material on what people think and say about services, and which services they value
• guidance on end of life care produced by authoritative sources, such as Marie Curie Cancer Care, the National End of Life Care Programme, and Skills for Care
• a workshop held at SCIE in 2013 with carers of people who have died
• practice examples
• a SCIE Project Advisory Group (of commissioners, providers, carers and service users), whose role was to review the way the guide was written and produced to ensure that it reflected real-life experiences and practice.

Research methodology

Evidence was drawn from over 70 papers, most of which were research, guidance and policy papers (see reference list). We included papers that were about:

• factors that influenced whether or not an adult (aged 18+) who wished to was able to die at home
• people who were considered to be at the end of life, that is, people who were expected to die within 12 months
• research indicating preferences and estimates of the number of people who want to die at home
• factors that support people to die at home or prevent it
• costs associated with dying at home (compared with costs of dying elsewhere – in a hospice or hospital)
• carers’ needs while caring. Interventions to support carers after the death of their loved ones, for example bereavement counselling, were not included.

Most of the material included was from the UK, and most was published in the period from 2008 to 2012.