Identifying the preferred place of death (PPoD) of incurable cancer patients and their family caregivers is important for the delivery of end-of-life care that meets their needs. The PPoD was not studied before in our region where talking with patients about death is largely perceived as unacceptable. Our aim was to study the PPoD of Egyptian patients with incurable cancer and their family caregivers and the actual place of death (APoD) of these patients.
A prospective observational cohort study that included 92 patient/family caregiver dyads. Patients and family caregivers were asked about their PPoD (home, hospital or other) in the event of patient’s death. Patients were followed up until death to know the APoD.
Seventy-nine (86%) dyads answered the question about their PPoD. Home was the PPoD in 74 (93.7%) patients as well as their family caregivers. The congruence in the PPoD between patients and family caregivers was 94.9% (Kappa = 0.573). The APoD was home in 65 (82.3%) patients and hospital in 14 (17.7%). Overall, 78.5% of patients died in their PPoD; however, the kappa value was low (=0.013). Similarly, the congruence between caregivers’ PPoD and APoD was poor (Kappa = 0.013). Patients who preferred death at home were more likely to die in their PPoD (p = 0.001).
The results suggest that, in the absence of the stand-alone hospice model, home is the PPoD for the vast majority of Egyptian patients with incurable cancer and their caregivers. Although the majority of patients die at home, other patients die in hospital contrary to their home death preference.
Clinical trial identification
Legal entity responsible for the study
Kasr Al-Ainy School of Medicine, Cairo University.
Has not received any funding.
All authors have declared no conflicts of interest.