IC-patiënten die thuis willen overlijden: hoe kun je deze laatste wens vervullen?

OBJECTIVE: To make an inventory of the number of intensive care (ICU) patients per year in the Netherlands who have been discharged home to die, and the conditions under which this does or should take place. DESIGN: Descriptive, survey study. METHOD: A survey was conducted across all ICU departments in the Netherlands in the spring of 2012. They were approached in writing and requested to answer a few questions about the possibility of immediate discharge home for ICU patients with a short life expectancy and receiving palliative care. RESULTS: A total of 46 surveys (52%) was returned from the 89 ICUs approached. Of these, 21 (46%) had discharged patients home at the request of the patient or their family so that the anticipated death could take place at home. Of the respondents, 39 (85%), supported discharge home for these patients, and 7 (15%) were opposed to it. These opinions were equally divided across all three ICU levels in the Netherlands. Higher-level ICUs had discharged patients home more often in comparison with lower-level ICUs (19%, 43% and 75% for levels 1, 2 and 3, respectively). The preconditions for transfer can be subdivided into patient conditions, care conditions and general conditions. CONCLUSION: ICU patients do sometimes want to die at home. It does not happen every day, but the wish is often granted in the Netherlands. There are certain general and patient-related conditions that have to be fulfilled. This article suggests a national guideline that could provide support on this subject

Intensive care patients who want to die at home:how can we fulfil this last wish?

OBJECTIVE: To make an inventory of the number of intensive care (ICU) patients per year in the Netherlands who have been discharged home to die, and the conditions under which this does or should take place.DESIGN: Descriptive, survey study.METHOD: A survey was conducted across all ICU departments in the Netherlands in the spring of 2012. They were approached in writing and requested to answer a few questions about the possibility of immediate discharge home for ICU patients with a short life expectancy and receiving palliative care.RESULTS: A total of 46 surveys (52%) was returned from the 89 ICUs approached. Of these, 21 (46%) had discharged patients home at the request of the patient or their family so that the anticipated death could take place at home. Of the respondents, 39 (85%), supported discharge home for these patients, and 7 (15%) were opposed to it. These opinions were equally divided across all three ICU levels in the Netherlands. Higher-level ICUs had discharged patients home more often in comparison with lower-level ICUs (19%, 43% and 75% for levels 1, 2 and 3, respectively). The preconditions for transfer can be subdivided into patient conditions, care conditions and general conditions.CONCLUSION: ICU patients do sometimes want to die at home. It does not happen every day, but the wish is often granted in the Netherlands. There are certain general and patient-related conditions that have to be fulfilled. This article suggests a national guideline that could provide support on this subject.</p