title: Prevalence of enduring power of attorney and barriers towards it in community geriatric population in Counties Manukau Health.
abstract: OBJECTIVE
  Enduring power of attorney (EPA) is a simple and easy-to-set-up legal document which protects the wishes of the donor, as well as preventing significant psychological and social cost for the patient and their family when long-term residential care needs to be arranged due to the patient's increasing care requirements. It also reduces the significant cost in hospital beds days for the district health board involved while awaiting the Protection of Personal and Property Rights order. However, the prevalence of EPA is low in the geriatric population who arguably need it the most. This study aims to identify the barriers in obtaining an EPA in this population.
  
  
  METHODS
  Using a cross-sectional design, 100 individuals seen in community geriatric clinics or home visits in Counties Manukau Health between June to September 2015 were surveyed.
  
  
  RESULTS
  There was no significant difference in prevalence of EPA between those with cognitive impairment and those without (40.4% and 35% respectively with difference in proportion 5% (95% CI: -14% to 24%, p 0.61)). New Zealand Europeans were more likely than other ethnic groups to have EPA (63.5% vs 10.4%, with difference in proportion of 53% (95% CI: 37% to 69%, p<0.001)). Forty-three participants without EPA gave lack of information as their reason for not having obtained one. The majority of those without EPA (49 participants) felt that their doctor or lawyer would be the best person to convey such information to them, as opposed to mass media such as TV or internet.
  
  
  CONCLUSIONS
  EPA has not been widely acknowledged as an important aspect of health and legal planning by the participants of this survey, predominantly due to the lack of knowledge in the general public and financial barriers. Increased efforts to educate and support uptake could have positive personal and social outcomes.
authors.affiliation: Department of Geriatrics, Counties Manukau Health, Auckland.
authors.forename: So-Jung
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Department of Geriatrics, Counties Manukau Health, Auckland.
authors.forename: Heather
authors.initials: H
authors.lastname: Astell
mesh_terms: D016223:Advance Directives / Q000208:ethnology* / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D057226:Information Seeking Behavior; D019359:Knowledge; D008297:Male; D016743:Mental Competency; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*; D014918:Wills / Q000706:statistics & numerical data