# How the COVID-19 pandemic shaped Canadians’ preferences for setting of dying: Comparison of two panel surveys

## TL;DR

This study found that the COVID-19 pandemic changed Canadians' preferences for where they want to die, especially reducing interest in nursing homes.

## Contribution

The study reveals a significant decline in preference for dying in nursing homes due to pandemic-related concerns.

## Key findings

- Preferences for dying at home, in acute/intensive care, and palliative care units remained unchanged.
- Preferences for dying in nursing homes significantly declined during the pandemic.
- Public concerns about nursing home care during the pandemic may have influenced this shift in preference.

## Abstract

The purpose of this article is to assess whether COVID-19 shaped Canadians’ preferred settings of dying. We compared data collected using the same survey from two independent but comparable sets of panel respondents, prior to and after the onset of the pandemic. A vignette methodology was used to assess preferences for dying in each of four settings: home, acute/intensive care, palliative care, and long-term residential care. Although preferences for dying at home, in acute/intensive care and palliative care units did not change, preferences for dying in nursing homes significantly declined. In the pandemic’s first and second waves, the spread of knowledge about problems of poor care, visitation restrictions, and fears of contagion in Canadian long-term residential care may have shaped public perceptions of and preferences for dying these settings. If this change persists, it may influence advance care planning decisions. That preferences for dying at home did not shift is noteworthy.