End-of-life care for older people in community hospitals

Background: The need for end-of-life care is likely to increase. Older people and those in rural areas do not have equal access to specialist palliative care services. End-of-life care is being offered to an increasing population of older people in community hospitals. Aims: To explore the views of senior clinical managers about end-of-life care in relation to the environment and staffing of community hospitals. Methods: Thirty semistructured interviews were carried out with senior clinical managers in community hospitals in the South East and South West of England. Results: Community hospitals can offer flexible accommodation for end-of-life care. Stable staff teams provide local knowledge and continuity of care. The relationship between local GPs and community hospital staff was key and nurses took the lead in the care of dying patients. Conclusions: Managers believe that community hospitals are appropriate places for older patients requiring end-of-life care. Issues arise around out-of-hours’ care and staff training. Conflicts of interest: none