ABSTRACT
Patients with advanced cancer receive care in a variety of settings: home, hospice, hospital, or continuing care facilities. When family members differ in their preferences for location of care, conflict results, but generally, families prefer palliative care at home unless they feel out of control. The success of home care relates to four factors: an able and available caregiver; comprehensive and reliable home care resources; the patients’s physical condition; and a suitable home environment. From the family’s perspective, the home environment facilitates a sense of normalcy, sustains relationships, and contributes to reciprocity between the ill person and family. Patients and families equate care at home with freedom and control. They have some degree of self-determination. Patients can rise, bathe, dress, eat, and visit according to their own routine. The hospital cannot accommodate that luxury and families must conform to routines and regimens.
