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Background Home care and hospices are gaining higher importance in providing end-of-life care. The main aim of this study is to investigate clinical decisions of healthcare professionals in north-eastern home-care services and hospices caring for patients in their end-of-life. Moreover, the study aims to study nurses' and physicians' opinions on palliative care. Methods A questionnaire was administered to healthcare personnel in 5 homecare services and 2 hospices in a regional health service trust in north-eastern Italy. The questionnaire is made of three parts: the first deals with clinical decisions for the last patient who died, the second investigates opinions on terminal care, while the last collect data on participants. Results 42 subjects have been enrolled, most of them are nurses, 64,1% without bioethics training and 53,8% without palliative care training. All the End- of-Life Decisions (DEL) were “non-treatment” decisions. None of the participants discussed the potential life-shortening effect with the patient. The involvement of patients' relatives in terminal care was meaningful for 86% of the professionals. The participants reported they usually discuss terminal issues only when patients or relatives ask for them, but palliative care seems to be the most discussed care-related topic. Conclusions Comparison with previous studies can't be performed because of the small number of participants. DEL were exclusively “non-treatment”. We found relevant data about options of shortening life, which was not discussed at all. Mainly only the professionals who give great importance to patient's religious beliefs discussed spiritual themes with them. Finally, the professionals trained in palliative care were more comfortable starting to talk to patients about the possibility of receiving palliative care. Key messages This study investigates clinical decisions taken by professionals in home-care and hospices in terminal ill patients care and professionals ‘opinions on palliative care. Communication on palliative care (PC) has been widely investigated: professionals trained in PC were more comfortable starting to talk to patients about the possibility of receiving PC.

Perception of end-of-life decisions by healthcare professionals in home palliative care and hospice