Intra-Family End-Of-Life Conflict: Findings of a Research Investigation to Identify Its Incidence, Cause, and Impact.

With few investigations of intra-family end-of-life conflict, this study sought to identify its incidence, cause, and impacts. A questionnaire was completed by 102 hospice/palliative nurses, physicians, and other care providers in Alberta, a Canadian province. Participants reported on how often they had observed intra-family conflict when someone in the family was dying, and the impacts of that conflict. 12 survey participants were then interviewed about the intra-family conflict that they had encountered, with interviews focused on why conflict occurred and what the impacts (if any) were. Nearly 80% of families were thought to experience end-of-life conflict, periodically or continuously, among various family members. The interviews confirmed three reasons for intra-family end-of-life conflict and three conflict outcomes that were revealed in a recent literature review. The findings indicate routine assessments for intra-family end-of-life conflict are advisable. Attention should be paid to preventing or mitigating this conflict for the good of all.

Location of Death in Developed Countries: Are Hospitals a Primary Place of Death and Dying Now?

Hospitals used to be a common site of death and dying. This scoping project sought published and unpublished information on current hospital death rates in developed countries. In total, death place information was gained from 21 countries, with the hospital death rate varying considerably from 23.9% in the Netherlands to 68.3% in Japan. This major difference is discussed, as well as the problem that death place information does not appear to be routinely collected or reported on in many developed countries. Without this information, efforts to ensure high quality end-of-life (EOL) care and good deaths are hampered.

Hospital utilization by older and younger patients in Canada: pre-pandemic findings.

Many countries are experiencing a post-pandemic surge in hospital utilization along with accelerating population aging. Maximal hospital efficiency is required, with utilization evidence essential for identifying appropriate hospital or broader health system reforms. We offer an investigation of the most recent pre-COVID year (2019-2020) of complete population-based hospital utilization data to describe and compare the use of hospitals by older (65+) and younger (0-64) people admitted for inpatient services in Canada. We found that 35.7% of all 1,888,133 admitted individuals and 39.8% of all 2,543,227 hospital episodes involved people aged 65+, representing 4,963,766 or 17.1% of the study population. This study, as do previous Canadian and other ones, found hospitals admit more younger people than older people. The admission and care patterns of both younger and older patients reveal a need for more community-based services to shorten older patient hospitalizations and prevent avoidable hospitalizations by both younger and older people.