Dying of cancer. The place of death and family circumstances.

Malignant neoplasms confer a special significance to the relationship between terminally ill patients and their immediate environment and directly influence the patient's place of death. This study analyzed the factors that influenced the place of death of cancer patients in Majorca (Balearic Islands, Spain). A survey was carried out among 335 surviving relatives who acted as primary care-givers. Information from interviews and data from medical records showed that 46% of the deaths occurred at home. The patients' place of residence (two of three patients from rural areas died at home and two of three patients from urban areas died in the hospital) and their sociocultural level (a higher proportion of deaths occurred in the hospital among patients of lower socioeconomic levels) were the family and social factors that had the greatest influence in determining the place of death. The opinions of those interviewed, the majority of whom were women (female/male ratio, 3.5:1), as to the admission and discharge of the deceased from the hospital and the impact on the family of the patient's death were analyzed. There were marked differences in the overall perception of the terminal phase of illness in hospital-centered and home-centered groups. The relatives of those who died at home were significantly less distressed.