252P - Preferred place of death among terminally ill cancer patients: A single centre observational study from India

Background

The place of death is an important aspect of end-of-life care. An individual achieving his or her preferred place of death (PPOD) is a quality marker of good death. Concordance in the wishes of the patient and family is also equally important. Not much data is available on the reasons pertaining to PPOD in the Indian population. We aimed to identify the PPOD among terminally ill cancer patients and their reasons. We also assessed the concordance between patient and primary family caregiver (PFCG) regarding the same.

Methods

A questionnaire-based cross-sectional survey was done among terminally ill cancer patients and their PFCG, when admitted to the palliative care ward in BRA IRCH, AIIMS, New Delhi. After obtaining ethical committee approval, patients satisfying eligibility criteria were prospectively recruited and informed consent was taken. The questionnaire included socio-demographic details, questions about the preferred place of death, and their reasons for the patient and PFCG.

Results

A total of 185 patients were recruited. Home was the PPOD for 115(62%) patients, while 62(33%) preferred palliative care ward and 8(5%) favored nursing homes.48 (26%) patients had discussed their PPOD with PFCG and 16% of the PFCGs agreed with their loved ones. Among 115 patients with home as PPOD, 60 (52%) wanted a peaceful death without any intensive procedure, 37 (32%) wanted care only from their loved ones, 35 (30%) did not like long hospital stays, and 28 (24%) did not want to financially overburden their family. Among 70 patients who had PPOD other than home, 49(70%) wanted a pain-free death, 32(45%) feared inaccessibility to medical care at times of emergency and 28 (40%) did not want to depend on family for self-care.

Conclusions

Home was the PPOD for almost two-thirds of the patients. However, we observed a lack of consensus regarding PPOD between patients and their PFCG. We should address this issue, and effective communication about PPOD between the patient and PFCG should be encouraged and both should come to similar terms in this regard.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.