Factors influencing older adults to complete advance directives.
OBJECTIVE
The purpose of this study was to determine the factors which influence advance directive (AD) completion among older adults.


METHODS
Direct interviews of hospitalized and community-dwelling cognitively intact patients > 65 years of age were conducted in three tertiary teaching settings in New York. Analysis of AD completion focused on its correlation with demographics, personal beliefs, knowledge, attitudes, and exposure to educational media initiatives. We identified five variables with loadings of at least 0.30 in absolute value, along with five demographic variables (significant in the univariate analyses) for multiple logistic regression. The backward elimination method was used to select the final set of jointly significant predictor variables.


RESULTS
Of the 200 subjects consenting to an interview, 125 subjects (63%) had completed ADs. In comparing groups with and without ADs, gender (p < 0.0002), age (p < 0.0161), race (p < 0.0001), education (p < 0.0039), and religion (p < 0.0104) were significantly associated with having an AD. Factors predicting AD completion are: thinking an AD will help in the relief of suffering at the end of life, (OR 76.3, p < 0.0001), being asked to complete ADs/ or receiving explanation about ADs (OR 55.2, p < 0.0001), having undergone major surgery (OR 6.3, p < 0.0017), female gender (OR 11.1, p < 0.0001) and increasing age (76-85 vs. 59-75: OR 3.4, p < 0.0543; < 85 vs. 59-75: OR 6.3, p < 0.0263).


CONCLUSIONS
This study suggests that among older adults, the probability of completing ADs is related to personal requests by health care providers, educational level, and exposure to advance care planning media campaigns.
Alano
Gloria J
GJ
North Shore Long Island Jewish Health System, New Hyde Park, New York 11040, USA. gloriajmd@yahoo.com
Pekmezaris
Renee
R
Tai
Julia Y
JY
Hussain
Mohammed J
MJ
Jeune
Jose
J
Louis
Betina
B
El-Kass
Gabriel
G
Ashraf
Muhammad S
MS
Reddy
Roopika
R
Lesser
Martin
M
Wolf-Klein
Gisele P
GP
D032722:Advance Care Planning; D016223:Advance Directives; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D004522:Educational Status; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009518:New York; D010358:Patient Participation; D012737:Sex Factors