Oxford Institute of Population Ageing, University of Oxford, United Kingdom; Kellogg College and Oxford Martin School, University of Oxford, United Kingdom.
Health Policy. 2019 Apr;123(4):435-439. doi: 10.1016/j.healthpol.2019.01.013. Epub 2019 Feb 2.
Increasingly, age of death is postponed until very old age, and care of those who are dying is challenged by medical co-morbidities and the presence of dementia. Although most people would prefer to die at home, currently in England and Wales only about 20 per cent of those aged 65 years and over die at home, and this proportion falls to about 10 per cent among those aged over 85 years. To explore recent and likely future trends in age and place of death, mortality statistics from 2006 to 2013 were analysed and projected to 2050 using age- and gender-specific rates. Results confirmed recent increasing age at death and indicated a trend for increasing proportions of older people to die at home. Projections indicated large increases in home-based deaths, particularly for men aged 65 and over. Consistent with people's wishes, there may be a partial return to the view that dying at home is a normal experience. Resource allocations are likely to need to shift to support people dying at home and their formal and informal carers.
死亡年龄越来越晚，高龄人群中并存的多种医学疾病和痴呆使临终关怀面临挑战。尽管大多数人更愿意在家中离世，但目前在英格兰和威尔士，只有约 20%的 65 岁及以上人群在家中离世，而 85 岁以上人群的这一比例则降至约 10%。为了探究近期及未来死亡年龄和地点的趋势，分析了 2006 年至 2013 年的死亡率统计数据，并使用年龄和性别特定的死亡率对 2050 年进行了预测。结果证实了最近死亡年龄的增长，并表明在家中离世的老年人比例呈上升趋势。预测表明，在家中离世的人数将大幅增加，特别是 65 岁及以上的男性。与人们的愿望一致，人们可能会部分回归认为在家中离世是一种正常经历的观点。资源分配可能需要转向，以支持在家中离世的人群及其正式和非正式的护理人员。
