Dying at home: a decision in palliative care, an integrative review

Introduction: Palliative care allow to develop social policies and innovative health, focused on the needs and preferences of patients, combining scientific knowledge, skills and attitudes to promote the excellence of care. Also promote a holistic care which improves the com- fort and quality of life of the patient and family, through an approach of the problems associated with life- threatening diseases, preventing and relieving suffering by early identification and assessment of pain and other physical problems, psychological, social and spiritual. Care the patient at home is important to respect the preferences of patients and to provide humanized end-of- life care. Aims: To demonstrate the need to integrate palliative care in home care. Methods: Review of Literature in databases (CINHAL, MEDLINE, ISI). The search was guided by the follow keywords: “palliative care”, “die at home” and “preferences”. As inclusion criteria we defined: English-language articles published after 2003, in full text, with abstract and references available and, analyzed by experts. Results: We found a total of 45 articles which show that 51 % of patients prefer to die at home but sometimes that it is not possible. Palliative care enable early intervention in the illness trajectory as well as personalized care aproaching effectively the needs of patients and families, providing an improved quality of life and reducing the need for hospitalizations, painful and dis- proportionate. Conclusion: It is essential to develop home palliative care teams (HPCT) to deliver quality care and implement interventions, given the management of symptoms, assessment and care planning, monitoring, preparation and sup- port in bereavement. Given the guidelines of the EAPC, is needed one HPCT per 100 thousand inhabitants. To achive this goal is vital to have health professionals with specializes education and training in palliative care.