May 22, 2009 It's a common tale: a grandparent's health begins to fail and, realistically, their death is imminent. Often those older patients are rushed to hospital, taken out of their homes for treatment that will likely only extend their life by a few days.
University of Alberta researcher Donna Wilson is hoping this can change and already has seen some drastic changes in where Canadians are choosing to die.
Wilson looked at mortality data of Canadians dating back to 1950. Up until 1994, 80 per cent of Canadians were choosing to pass on in a hospital bed. But since the mid-'90s there's been a drastic change in the number of people going to hospital to die. The number is now down to 61 per cent.
"So after years of [the numbers] going up, we have completely reversed that and are now at the 1960 level, before there was free hospital care in Canada," said Wilson, who adds the decrease in numbers of people dying in hospital has happened without direct health policy or government planning.
Her next study she wants to find out why this trend is happening. But she already has some ideas on the huge swing.
"My guess is that a lot of it has to do with the fact that death is no longer unexpected," said Wilson. "A lot of people are dying at an advanced age and you begin to accept that fact that it's going to happen and it [can be] a dignified event. If you take the person to the hospital . . . care is by strangers rather than family members."
This study, published in Social Science & Medicine, comes at a good time as Canadians watch the population age. Wilson predicts the number of people dying each year will double, maybe even triple, in the next 10-20 years because of the aging baby-boomer population.
"This study can help government plan for the future," said Wilson, who added that, about 250,000 people die per year in Canada. If death rates in hospital were to rise to 80 per cent when the baby boomers begin to die, every single hospital bed in Canada would be taken up for three days of the year. Wilson would like to see only 40 per cent of Canadians dying in hospital in the years to come, so as to take stress off the health-care system.
"The fact that every year we're going to have more and more people passing away, and needing a bit of help at the end of life scares me when you're not building anymore hospitals and you're not making hospitals any better," said Wilson.
She's calling on government to help support the trend of people dying at home.
"We need to start putting more money in to home care and develop some hospices, have some courses for families and maybe build a few more nursing home beds," said Wilson, who adds this not only helps the health-care system but also can provide a more dignified and potentially less painful death for the patient.
"All the drug therapies that keep people comfortable in hospital can be used at home," said Wilson. "You've got much more choice. You're not going to be force-fed; you're not going to have an intravenous drip started on you that is painful.
"I think we have a very healthy population who can look after dying people."
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- Donna M. Wilson, Corrine D. Truman, Roger Thomas, Robin Fainsinger, Kathy Kovacs-Burns, Katherine Froggatt, Christopher Justice. The rapidly changing location of death in Canada, 1994-2004. Social Science & Medicine, 2009; 68 (10): 1752 DOI: 10.1016/j.socscimed.2009.03.006
Note: If no author is given, the source is cited instead.