Abstract

GAUDENCIO, Margarida. The Last Hours/Days of Life at Hospital Versus at Home. Gaz Med [online]. 2022, vol.9, n.4, pp.348-352.  Epub Dec 31, 2022. ISSN 2183-8135.  https://doi.org/10.29315/gm.v1i1.617.

Population aging is one of the main social transformations of the 21st century, with implications for all sectors of society. The aging is accompanied by an increase in the prevalence of oncological and chronic, progressive diseases, with a high degree of functional dependence, cognitive decline, decreased quality of life and an increase in the mortality rate. The social transformation that we are witnessing implies the urgent need to plan the allocation of end-of-life support services, namely the development of palliative care. Worldwide, the end of life is very common in a hospital and Portugal is no exception. Several studies have demonstrated enormous variability in the quality of end-of-life care in acute hospitals. Some studies highlight the problem of this kind of care in acute hospitals, as well as the great difficulty that doctors have in deciding when to suspend curative care and initiate palliative support. According to some data, most Portuguese prefer to die at home, however, the reality is different. The lack of access to medical care is one of the main reasons for refusing the death process at home. Most family members, although they can defend death at home, understand that it should occur in the hospital due to the need for permanent care and the lack of home support that guaranteed quality care. So, there is an urgent need to rethink national health policies, seeking to improve accessibility to palliative care, namely with the creation of community/home teams, in order to improve the support of these patients at home and thus free the acute hospitals.

Keywords : Home Care Services; Hospitalization; Medical Futility; Palliative Care; Respect; Terminal Care.

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