Difference is opinion regarding end-of-life between older patients and their family, a Thai perspective

Making decision for the love ones toward the end-of-life is a sensitive and complex task. Having established advance care plan is rarely occurred in Eastern culture. The discordance among patients and decision makers has been documented in literature but never been explored in Thailand. We conducted a survey among geriatric patients using 5-category likert scale, 13-situation-based questionnaire. We also enquired the families to rate how they believed what older patients would have thought regarding issues in end-of-life care. Elderly and their families demonstrated fairly similar attitude for most of the items inquired. However, significant higher proportion of patients wished not to be a burden to their families and not to prolong suffers when chance of survival is slim. Of note, only 45.2% of patients wished to pass away at home while 70% of family believed that older patients would have wanted to die at home. Factor associated with agreeing to die at home were age less than 75, having education more than 4 years and being single with OR of 2.93 (1.39 to 6.16; p=0.005), 2.76 (1.30 to 5.87; p=0.009) and 2.78 (1.33 to 5.83; p=0.007),respectively