Abstract

Background: Many people living with advanced cancer are elderly and increasing numbers of older patients live alone. Whilst health status will clearly help to determine where an older adult can live, this study will explore the possibility that living arrangements may themselves have consequences for the health experience of older adults towards the end of life.

Aims: To establish why and how older adults with cancer, living alone with advanced disease, have distinct experiences, needs and preferences for care, which merit attention.

Methods:In-depth qualitative interviews with 40 people, half of whom will live alone. Participants are being recruited from general practices in North West England, if they fulfil the following criteria:aged 75 years and over; a documented cancer diagnosis cancer; the GP responds ‘no’ to the question: ‘Would you be surprised if this person were to die in the next 12 months’. The baseline face-to-face interviews explore and compare the perceptions and experiences of participants who live alone and those who live with others, to understandwhy uptake of care services may differ with living arrangements;how living alone influences quality of life and health outcomes and the factors associated with people’s preferences for place of care. Quantitative data are being collected on service contacts, costs, functional status, cognitive function, depression and loneliness. Follow-up telephone interviews are planned at three and six months with participants and selected carers. Qualitative data will be analysed using a Framework approach.

Findings: This study will begin to determine how health and social care services can best support older adults living alone at the end of life and provide data on the research approach to inform future work.