People’s first priority at the end of life is to be free from pain and discomfort. But for too many people choosing to die at home means that their symptoms, particularly pain, will not be as well managed when compared to other care settings. In England, research has shown that pain management at home has been consistently rated as poor in comparison to hospice inpatient units, care homes and hospitals, indicating that previous solutions have not addressed the core problem, and that more work is needed to address this inequality.
This study looks at how pain management for dying people being cared for at home might be improved. We explore in detail the experiences of professional healthcare staff, from community nurse specialists and specialist palliative care clinicians to GPs and pharmacists, to understand what factors contribute to good pain management.
Improving pain management at home for people at the end of life requires healthcare services to identify and address the factors that enable or impede good outcomes. We find that pain management at home for people at the end of life is affected by factors linked to both strategic and clinical considerations.