title: Opiniones: end-of-life care preferences and planning of older Latinos.
abstract: OBJECTIVE
  To measure end-of-life (EOL) care preferences and advance care planning (ACP) in older Latinos and to examine the relationship between culture-based attitudes and extent of ACP.
  
  
  METHODS
  Cross-sectional interview.
  
  
  METHODS
  Twenty-two senior centers in greater Los Angeles.
  
  
  METHODS
  One hundred forty-seven Latinos aged 60 and older.
  
  
  METHODS
  EOL care preferences, extent of ACP, attitudes regarding patient autonomy, family-centered decision-making, trust in healthcare providers, and health and sociodemographic characteristics.
  
  
  RESULTS
  If seriously ill, 84% of participants would prefer medical care focused on comfort rather than care focused on extending life, yet 47% had never discussed such preferences with their family or doctor, and 77% had no advance directive. Most participants favored family-centered decision making (64%) and limited patient autonomy (63%). Greater acculturation, education, and desire for autonomy were associated with having an advance directive (P-values <.03). Controlling for sociodemographic characteristics, greater acculturation (adjusted odds ratio (AOR)=1.6, 95% confidence interval (CI)=1.1-2.4) and preferring greater autonomy (AOR=1.6, 95% CI=1.1-2.3) were independently associated with having an advance directive.
  
  
  CONCLUSIONS
  The majority of older Latinos studied preferred less-aggressive, comfort-focused EOL care, yet few had documented or communicated this preference. This discrepancy places older Latinos at risk of receiving high-intensity care inconsistent with their preferences.
authors.affiliation: Brookdale Department of Geriatrics and Palliative Medicine, Mount Sinai School of Medicine, New York, New York, USA. amy.kelley@mssm.edu
authors.forename: Amy S
authors.initials: AS
authors.lastname: Kelley
authors.forename: Neil S
authors.initials: NS
authors.lastname: Wenger
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Sarkisian
mesh_terms: D032722:Advance Care Planning; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D003657:Decision Making; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D026684:Personal Autonomy; D011788:Quality of Life; D013727:Terminal Care / Q000523:psychology*