A Survey of Opinions Regarding wishes Toward the End-of-Life among Thai Elderly
Varalak Srinonprasert MD*, Aksara kajornkijaroen MD*, Patawee Na Bangchang MD**, Genis Wangtrakuldee MD**, Janewit Wongboonsin MD**, Vanasiri Kuptniratsaikul MD**, Sakaorat Kornbongkotmas MD*, Jintana Assanasen MD*, Rungnirand Praditsuwan MD*
Affiliation : Part of this study was presented as a poster presentation at Advance Care Planning and End of Life Care 2011 Conference; London * Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Knowledge of wishes toward the end-of-life is crucial for carrying out high quality palliative care. However,
advance directive is not commonly available among Thais, particularly for non-cancerous older patients.
Objective : The present study aimed to explore Thai older person’s wishes toward cares needed at the end-of-life.
Material and Method: A convenience sample of 100 older patients, who attended geriatric clinic at a university hospital in
Thailand, was recruited. A 3-page questionnaire developed to suit Thai culture was utilized to elicit opinions concerning
circumstances around end-of-life period.
Results : All participants were Buddhists with mean age of 75.9 (8.2). Toward the end-of-life, the majority wanted to know the
truth about their illnesses and to be free from uncomfortable symptoms. Seventy-five percent did not want “prolong-life”
treatments when chance of surviving is slim. Age less than 70 and having education of no more than 6 years were factors
associated with being unwilling to prolong suffering with OR of 9.88 (1.20-81.57, p = 0.03) and 3.15 (1.11- 8.95, p = 0.03),
respectively. Interestingly, fifty-six percent of elderly did not want to die at home. Age less than 70 was the only factor
significantly associated with being unwilling to die at home with OR of 2.80 (95% CI = 1.05-7.47, p = 0.04).
Conclusion : The present study illustrated older persons’ opinions in relation to cares at the end-of-life from a Thai perspective,
which showed some similarities and differences when compared to western countries. These opinions should be crucial for
carrying out optimal and qualitative end-of-life care for older people when advanced care planning is not in place for the
individual.
Keywords : End-of-life care, Advance care planning, Elderly, Questionnaire, Thailand
