Le dernier mois de l'existence: Les lieux de fin de vie et de décès en France

This article describes the residential trajectories and places of residence of patients over their last month of life, based on the end-of-life survey La Fin de vie en France, conducted in 2010 on a representative sample of deaths occurring in December 2009. The physicians who had certified the deaths were questioned about the end-of-life circumstances. While three in five people die in hospital, only half were in hospital a month before their death. Over that last month, the most common move is from home to hospital. Those already in hospital or living in a retirement home a month before death are very likely to remain there until they die. Multivariate analyses show that age and sex influence the end-of-life trajectory: it is the oldest individuals, and women, who are most likely to spend their last month in a retirement home. Symptoms, type of disease and purpose of treatment also play a role. Not all clinical situations can be handled through home care: treatment of acute episodes, respiratory distress and digestive problems are more often treated in hospital, mental disorders in retirement homes and mobility problems in both these places.