Why the study?
Do end-of-life home care clients with heart failure have different clinical needs and prognostic recognition compared to those with cancer?
Do end-of-life home care clients with heart failure have different clinical needs and prognostic recognition compared to those with cancer?
Heart failure patients receiving end-of-life home care have similar or greater clinical needs than cancer patients but are significantly less likely to be recognized as having a terminal prognosis.
HF home care clients may have unmet needs from lower prognostic recognition; leaves open whether targeted tools could improve equity in end-of-life care.
Individuals with heart failure experience complex symptoms and have a poor prognosis, comparable to those with cancer. However, people with heart failure are less likely to be recognized as needing palliative care. We compared seriously ill home care clients with cancer versus those with heart failure to explore differences between them using existing data from the Resident Assessment Instrument for Home Care (RAI-HC). The sample included 1,475 older adults (65+) in Ontario who had a prognosis of less than 6 months or severe health instability. Clients with heart failure were significantly older (p < .0001) and experienced significantly higher rates of impairment in activities of daily living (p = .005), cognitive impairment (p < .0001), and severe health instability (p < .0001), but were significantly less likely to have a prognosis of less than 6 months (p < .0001). Home care clients with heart failure have needs similar to those with cancer yet are typically not identified as having a terminal prognosis.
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Fernandes et al. (2014) studied this question.
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