Deaths at home during the pandemic: preference or pressure?
2nd August 2021
A recent editorial in the BMJ has highlighted data from the UK’s Office for National Statistics showing an increase in the number of deaths from all causes in private homes in 2020. Average deaths at home between 2015 and 2019 were 125,000 and they increased by about one third to 167,000 in 2020. Around 41,000 more people died in private homes than in a normal year. Only a small number (just over 3000 or 7%) were recorded as being due to COVID-19.
Most of these deaths at home were from underlying causes seen every year: dementias (which increased by 65%), heart and lung diseases, cancers, and neurological diseases. This represents a significant shift of people dying of non-COVID-19 causes, from hospital to home.
More research is needed to understand if the increase in deaths in private homes is a reflection of preference, or poor quality alternatives because of pressured hospital services. Were symptoms controlled and how were families, preferences, and priorities supported? How easily were services accessed, including by remote consultation?
The editorial highlights Cicely Saunders International’s recent Action Plan for Palliative Care which sets out achievable actions to ensure that everyone has access to palliative care, wherever they live, and wherever they are cared for.
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1437 (Published 08 June 2021)
Irene J Higginson, Professor of Palliative Care & Policy, David Brooks, Macmillan consultant in palliative medicine, Stephen Barclay, general practitioner