End-of-Life Care Preferences of the Terminally Ill Patients from a Selected Setting, Tamil Nadu-Pilot Study Findings

Providing excellent care for a dying patient is something all patients deserve. Institute of Medicine Committee defined good death as one that is in accord with patient's and family's wishes. End-Of-Life care preferences of the terminally ill patients vary with culture which is reported by various researchers around the globe.

AIM: To explore the end-of-life care preferences among the terminally ill patients from a selected setting of Tamil Nadu, India.

MATERIALS AND METHODS: Descriptive exploratory design was adopted. For this pilot study, 10 terminally ill patients were interviewed using a structured questionnaire on End-of-Life Care Preferences in a selected hospice.

RESULTS: EOL being a naïve concept in India, interestingly 30% had communicated their EOL wishes to family members. Terminally ill patients valued sense of dignity more than controlling pain through medications if it muddled them. Nearly 60% of patients did not prefer life prolonging treatment if they did not have hope of recovery. An overwhelming majority of patients preferred home for EOL care and death. All the patients preferred that their spiritual beliefs be considered for EOL care. Majority wanted to remain autonomous in their decision making when they are capable and 60% preferred health care professionals to make the decisions when they are incapacitated. Majority preferred to fill a living will or an advanced directive. 9 out of 10 patients agreed for euthanasia or physician assisted suicide to be legally available.

CONCLUSION: Designing EOL care pathways based on EOL care preference which differs from culture to culture will ensure quality EOL care. Continuous and sustained effort to improve EOL research will definitely be a stepping stone for quality EOL care in India.