[Caring pathways of terminal cancer patients: a retrospective survey]

Caring pathways of terminal cancer patients: a retrospective survey. Introduction. The caring patways of terminal cancer patients of the Vallagarina district, dead in 2008, cared at home and/or by district services in the last 90 days of life of cancer patients, were retrospectively described. Aim. To describe the last 90 days of life of all patients dead for cancer. Methods. Data were collected from different sources: hospital discharge forms, local health unit informative systems, data bank of the palliative care service (PC), charts of PC and home care services and through interviews to caregivers, for patients cared by General practitioners (GPs). Results. Four caring pathways were identified: patients mainly cared by GPs, in nursing homes, in long term care or by the PC service. The rate of hospital admissions varies widely: 25% of potential days of care for GPs patients; 1.3% for PCs patients; same for length of hospital stay: mean duration 18.7 days for GPs and 5.6 days for PC patients. Only rarely the GPs activate other forms of care such as care by multidisciplinary teams (10.8% patients) or visits at home by GPs (12.7% patients). Caregivers would like more information on the clinical situation of the patient and on the different caring services, to be involved in the decision making process. Conclusions. Patients cared by GPs and PC Service experience different caring pathways. Lack of information to caregivers may profoundly impact the type of care received.