Outpatient Palliative Care Services to Latino Patients: A Closer Look into Advance Directives (S785)

•Describe the type of end of life care that Latino patients usually receive based on the barriers to care.•Describe how communication and goals of care conversations with Latino patients can affect their end of life care. Latino patients face many barriers to palliative care (PC) services and appropriate end of life (EOL) care. Previous studies have shown that Latino patients want more aggressive care and are less likely to sign a (Do Not Resuscitate) DNR compared to white patients. 1. Identify the number of patients that have completed an Advance Directive (AD) prior and after seeing a PC provider, 2. Evaluate the type of end of life care provided to Latino patients. A retrospective chart review performed from January 2015 to June 2016 of Latino patients referred to an outpatient PC consultation service at a new PC clinic in an urban academic center. Of the 30 Latino patients seen in clinic, 29 had either locally advanced or metastatic cancer and 1 renal disease on hemodialysis. Median age was 68.5 years old. Majority of consults (87%) were for symptom management. Upon initial PC consultation only 4 Latino patients (13%) had previously completed any type of AD. Out of the 26 patients without an AD, 16 (62%) completed one after a palliative care consultation and 10 (38%) did not. 14 out of 16 (88%) patients completed a healthcare proxy form or confirmed surrogate decision maker, and 10 out of 16 (63%) signed a DNR order. There were 18 deceased patients, out of which 11 (61%) died in a hospice setting and 7 (39%) died in the hospital, but 2 of the latter were DNR. A worrisome minority of Latino patients had completed AD prior to a PC consultation. Having EOL conversations were important PC interventions for Latino patients potentially resulting in less aggressive care at EOL.