Quality end-of-life care includes preferences for where a person dies. The majority of people prefer to die in their home. Research identifying factors that contribute to a person's choice of place of death remains limited. The 2009 Milton and Anne Sidney Prize recipient's commitment to palliative care and global health motivated him to study where people die in Botswana, South Africa. The findings from this study provide important foundational information to direct future research and guide the care of people dying in Botswana, a country with a population of approximately 2 million people.
The recipient traveled to Bostwana and secured 2005 and 2006 death certificate data from the Registry of Births and Deaths. The data collection for this study was immense and complex. The final sample consisted of 18,869 records. Nearly two-thirds of patients died in the hospital, and 48% of those deaths were related to HIV/AIDS. In addition, those who died in the hospital were nearly 20 years younger than persons who died at home. Many of the home deaths were older persons with an unknown cause of death. As this scholar points out, nurses are the "primary face of healthcare in Botswana, particularly in more rural areas where home deaths are likely to occur." He recommends that nurses collect data on the causes of death in the home through verbal autopsies, to improve the epidemiologic data collected in that country. There is also an enormous opportunity for nurses to provide holistic care to families as well as patients in the dying process and the subsequent bereavement period.
The findings of this study will be of direct benefit to the Republic of Botswana's Health Ministry, and has important implications for nursing practice and research. The data presented in this study will also help direct the education and nursing practice to better target care for a population of younger patients dying of HIV/AIDS. The recipient's background in philosophy combined with his career goal to be an advanced practice nurse in palliative care uniquely positions him to make substantial contributions to quality end-of-life care globally.
For his dedication and on-going commitment to the promotion of evidence based end of life care, the 2009 Milton and Anne Sidney Prize is awarded to clinician–scholar: James "Mark" Lazenby.
