Return to homeland: Bereaved caregiver perceptions of immigrant patient quality of death after repatriation to their country of origin, a retrospective cohort study.

OBJECTIVES

Terminally ill immigrant patients may wish to return to their homeland to die. However, the challenges and repatriation experiences faced by terminally ill Latinx immigrants who return to their country of origin (COO) remain underexplored. This study examines bereaved caregiver accounts of end-of-life (EOL) care and repatriation experiences of Latinx immigrants who returned to their COO following a terminal diagnosis.

METHODS

Bereaved caregivers were interviewed via telephone. Primary outcomes were patient repatriation prior to death and caregiver perceptions of patient quality of death (QOD). Secondary outcomes included repatriation barriers, symptom burden and management, health-care utilization, and location of death. Caregivers of deceased patients treated at a U.S. urban tertiary medical center from 2013 to 2020 who requested and returned to their COO for death were included. Deceased patient clinical and sociodemographic information was obtained from the chart review.

RESULTS

Nineteen caregivers of patients who returned to their COO were included, most (n = 15/19, 78.9%) from the Dominican Republic. Two patients experienced logistical challenges during travel to their COO. None received supplementary nutrition or ventilatory support. Most patients had well-controlled symptoms (12/19 had pain, 11/12 pain was controlled) and died peacefully with dignity (84.2%) at their preferred location (73.7%). Most caregivers reported that their loved one was happy with repatriation (89.5%) and that repatriation improved EOL quality of life (84.2%). QOD was rated favorably (average score of 4.2/5).

SIGNIFICANCE OF

RESULTS

QOD was favorable after repatriation. Successful repatriation is feasible and an important component of QOD that should be included in goals of care discussions.