The duration and degree of end-of-life dependency of home care clients and hospital inpatients

The investigation sought to describe and compare dependency among dying persons. To accomplish this, healthcare records of all decreased persons who received care over a 6-month period in one Canadian hospital (n = 150) and one home care department (n = 59) were reviewed. Only 36% of the home care clients died at home; all others (n = 38) were hospitalized. Almost all subjects had dependency needs on admission to care, with dependency increasing until all were completely dependent near death. Hospitalized home care clients had the longest documented average duration of total (partial and complete) dependency (81.3 days). Types of dependency (partial and complete) and progression in dependency were similar among subject groups, with the exception of 26% of hospital inpatients, who suddenly developed complete dependency until death. The duration of complete dependency varied between and among subject groups, which explains why a significant difference in lengths of complete dependency between hospital inpatients (M = 8.3 days) and home care clients who died at home (M = 4.1 days) was not found. In light of a dearth of research-based knowledge, this information should facilitate an improved understanding of the dependency needs of dying persons. Ultimately, it should assist end-of-life care planning and policy making.