Preference for death at home and associated factors among older people in the city of belo horizonte, brazil

Abstract

We examined people’s preferences for place of death and identified factors associated with a home death preference. We asked a representative sample (N = 400) of older people (≥ 60 years) residents in the city of Belo Horizonte, about their preferences for place of death in a situation of serious illness with less than a year to live. Data were analyzed using binomial regression to identify associated factors. 52.2% indicate home as the preferred place of death. Five variables were associated with preference for death at home: Those living with 1 child (odds ratio (OR)0.41; 95% confidence interval (CI):0.18-0.92; ref: Without children); being in education for up to 4 years (OR0.42; 95% CI:0.20-0.89; ref: Higher education); finding it difficult to live with the present income (OR3.18; 95% CI:1.53-6.62; ref: Living comfortably); self-assessed fair overall health (OR2.07; 95% CI:1.06-4.03; ref: Very good health) and selecting “choosing who makes decisions about your care” as the care priority that would matter to them the most (OR2.43; 95%CI:1.34-4.40; ref: Dying in the place you want). Most respondents chose home as preferred place of death. However, most residents of Belo Horizonte die in hospitals, suggesting that preferences are not being considered.