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This exploratory retrospective record review analyzes adult palliative and terminal patients who died in 2023 in Gelre Hospitals Apeldoorn, while waiting for terminal care at home or in hospices. Reasons included sudden health deterioration, hospice waiting lists, and transfer delays, along with uncertainty about care location and delays influenced by weekends. The study highlights starting points for improving end-of-life care alignment with preferences.",{"@graph":69,"@context":126},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/reasons-why-palliative-and-terminally-ill-patients-do-not-die-at-home-a-single-centre-study/442263/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/reasons-why-palliative-and-terminally-ill-patients-do-not-die-at-home-a-single-centre-study/442263.png","ImageObject",300,407,{"name":92,"@type":93},"Jasmine","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118,122],{"name":109,"@type":110,"acceptedAnswer":111},"What question does the study address?","Question",{"text":112,"@type":113},"It investigates why palliative and terminally ill patients die in the hospital instead of their preferred location of death (home or hospice).","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the study conducted?",{"text":117,"@type":113},"It used an exploratory retrospective review of electronic patient records for adult palliative and terminal patients who died in 2023 in Gelre Hospitals Apeldoorn while waiting for end-of-life care at home or in hospices.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the most common reasons patients did not die at their preferred location?",{"text":121,"@type":113},"Sudden deterioration of health status (31%), hospice waiting lists (27%), and transfer delays (21%).",{"name":123,"@type":110,"acceptedAnswer":124},"How do the findings inform potential improvements?",{"text":125,"@type":113},"They suggest starting points to better honor patients’ wishes and enhance the quality of end-of-life care in hospitals, potentially including other hospitals as well.","https://schema.org",{"og:url":83,"og:type":128,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":130,"canonical":83},"index,follow",{"doc_id":132,"site_id":62},442263,1790765313,{"code":4,"msg":5,"data":135},{"doc_id":132,"user_id":136,"nickname":92,"user_avatar":137,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":143,"language":144,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":145,"faqs":146,"seo_title":147,"seo_description":67,"update_tm":148,"read_time":41,"preview_page_count":4},2336478487870,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Martens et al. BMC Palliative Care (2026) 25:6 BMC Palliative Care  \n[https://doi.org/10.1186/s12904-025-01948-3](https://doi.org/10.1186/s12904-025-01948-3)  \nRESEARCH Open Access  \nReasons why palliative and terminally ill  patients do not die at home with end-of-life home care or in a hospice, but in the hospital:  \na single-centre study  \nJasmijn F. Martens 1,2, Berdine Koekoek2, Tjard R. Schermer 1,3* and Ingrid van Zuilekom4  \nAbstract  \nBackground In the final stages of life, patients discuss their wishes regarding their preferred location of death. However, this preferred location is not always the actual place of death. This study explores why palliative and terminal patients die in the hospital instead of their preferred location.  \nMethods This is an exploratory retrospective record review of adult palliative and terminal patients who died in 2023 in Gelre Hospitals Apeldoorn, the Netherlands, while waiting for terminal care at home or in hospices. Data were retrieved from electronic patient records, after which the reasons for not dying at the preferred location were analysed.  \nResults 74 patients were included, comprising 54. 1% women, with a mean age of 78.2 years (SD 11. 0) . The most common reasons why patients did not die at their preferred location were sudden deterioration of health status (31%), hospice waiting lists (27%), and transfer delays (21%) . Other reasons include uncertainty regarding the care location, failure to mark the terminal phase, and waiting for responses from preferred care locations. Delays in the transfer process due to the intervening weekend also seemed to play a role.  \nConclusions Sudden health deterioration and waiting lists at hospices seem to be the main reasons why patients die in the hospital instead of at their preferred location. The findings provide a starting point for formulating potential solutions to honour patients’ wishes more often and enhance the quality of end-of-life care in our hospital—and potentially in other hospitals as well.  \nKeywords Palliative care, End-of-life, Dying in the place of preference, Hospital, Hospice, Transfer delay, Transfer office, Home care  \n*Correspondence: Tjard R. Schermer [t.schermer@gelre.nl](t.schermer@gelre.nl)  \n1Gelre Hospitals, Science Office, PO Box 9014, Apeldoorn 7300 DS, the Netherlands  \n2Palliative care network and Center for Life Questions East Vel uwe, Albert Schweitzerlaan 31, Apeldoorn 7334 DZ, the Netherlands  \n3Department of Primary and Community Care, Radboud University Medical Center, Research Institute for Medical Innovation, PO Box 9101, Nijmegen 6500 HB, the Netherlands  \n4School of Health, research group Smart Health, Saxion University of Applied Science, PO Box 70 . 000, Enschede 7500 KB, the Netherlands  \n© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/l](vecommons.org/l)icenses/by-nc-nd/4.0/.  \nMartens et al. BMC Palliative Care (2026) 25:6  \nBackground  \nPalliative care aims to improve the quality of life of patients with life-limitin","cbCain3rnB97zkWu","https://ap.wps.com/l/cbCain3rnB97zkWu","pdf",1560933,12,"English","# Background\n# Methods\n# Results\n## Patient characteristics\n## Main reasons for not dying at the preferred location\n# Conclusions","[{\"question\":\"What question does the study address?\",\"answer\":\"It investigates why palliative and terminally ill patients die in the hospital instead of their preferred location of death (home or hospice).\"},{\"question\":\"How was the study conducted?\",\"answer\":\"It used an exploratory retrospective review of electronic patient records for adult palliative and terminal patients who died in 2023 in Gelre Hospitals Apeldoorn while waiting for end-of-life care at home or in hospices.\"},{\"question\":\"What were the most common reasons patients did not die at their preferred location?\",\"answer\":\"Sudden deterioration of health status (31%), hospice waiting lists (27%), and transfer delays (21%).\"},{\"question\":\"How do the findings inform potential improvements?\",\"answer\":\"They suggest starting points to better honor patients’ wishes and enhance the quality of end-of-life care in hospitals, potentially including other hospitals as well.\"}]","Reasons why palliative and terminally ill patients do not die at home - a single-centre study | PDF",1790699626]