Preference of the place of death.

Sir,

The report on “Preference of the place of death” is very interesting.[1] Kulkarni et al. noted that “majority of people surveyed by us, prefer to die at home, where they are relatively more comfortable.[1]” We would like to share our ideason this topic. According to a recent Chinese report, “home” is also the most preferred place of death.[2] Gu et al. also reported that “patients who lived in rural area, with lower education level and lived with relatives, expressed more preference to die at home.[2]“Another study from Taiwan, China, also reported that the terminally ill patients preferred to “die at home.[3]” Hence, there is no doubt that “die at home” seems to be the common preference of the terminally ill patients. Nevertheless, “dying in a favorite place” was not much of a concernfor Chinese patients, according to the perception of their health care providers.[3] Finally, it should also be noted that information on the preferred place of death might sometimes not be available from the patient,[4] but can be available from the relatives. Chen et al. noted that “family members knew the participant's preference for place of death[3]” was the main determinant that the patient expressed for preference to die at home. For those cases, De Roo et al. suggested using information from relatives.[5] It should be the role of the palliative care provider to seek information regarding the patient's preference and to “tailor effective interventions to help patients die at their place of preference.[6]” To manage the preference of the patient, the physician in charge has to work and collaborate with the patient-family caregiver.[7] It should be noted that not all patients’ relatives agree on the preferredplace of death,[7] and this is the issue for manipulation. “Caregiving burden of family caregivers” has to be well managed, and the social welfare support should be provided if required.[8] In fact, a report from Japan noted that support from family physician is also the main factor for terminally ill patients to prefer to die at home.[6]