scholarly journals Advance Care Planning in Older Adults With Multiple Chronic Conditions Undergoing High-Risk Surgery

JAMA Surgery ◽  
2019 ◽  
Vol 154 (3) ◽  
pp. 261 ◽  
Author(s):  
Victoria L. Tang ◽  
Ellis C. Dillon ◽  
Yan Yang ◽  
Ming Tai-Seale ◽  
John Boscardin ◽  
...  
Keyword(s):  
Older Adults ◽  
High Risk ◽  
Advance Care Planning ◽  
Chronic Conditions ◽  
Multiple Chronic Conditions ◽  
Care Planning ◽  
Advance Care

Frequency of Preoperative Advance Care Planning for Older Adults Undergoing High-risk Surgery

JAMA Surgery ◽  
2021 ◽  
pp. e211521
Author(s):  
Elle Kalbfell ◽  
Anna Kata ◽  
Anne S. Buffington ◽  
Nicholas Marka ◽  
Karen J. Brasel ◽  
...  
Keyword(s):  
Older Adults ◽  
High Risk ◽  
Advance Care Planning ◽  
Care Planning ◽  
Advance Care

Frequency of Preoperative Advance Care Planning for Older Adults Having High-Risk Surgery (RP318)

2020 ◽  
Vol 60 (1) ◽  
pp. 210
Author(s):  
Elle Kalbfell ◽  
Anna Kata ◽  
Anne Buffington ◽  
Nicholas Marka ◽  
Karen Brasel ◽  
...  
Keyword(s):  
Older Adults ◽  
High Risk ◽  
Advance Care Planning ◽  
Care Planning ◽  
Advance Care

scholarly journals What Predicts Advance Care Planning Among Older Adults: Perceived Health or the Number of Chronic Conditions?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 421-421
Author(s):  
YuHsuan (Olivia) Wang ◽  
Susan Enguidanos ◽  
Olivia Wang
Keyword(s):  
Older Adults ◽  
Advance Care Planning ◽  
Chronic Conditions ◽  
Care Planning ◽  
Health Care Proxy ◽  
Logistic Regression Models ◽  
Self Rated Health ◽  
Quality Of Death ◽  
Advance Care ◽  
Nationally Representative

Abstract Advance care planning (ACP) is associated with improved quality of death and better end-of-life care. Studies have found that both health status and chronic illness influence rates of ACP. However, little is known about the relative association of each factor with engaging in ACP. This study aims to identify the extent to which the number of chronic conditions and self-rated health predict engaging in ACP. We used data from the Health and Retirement Study, a nationally-representative longitudinal survey of older adults. The sample consisted of 2016 core interview respondents. We conducted logistic regression models to examine the association between self-rated health and the number of self-reported chronic conditions with three dependent variables: (1) ACP engagement (n=687), (2) AD completion (n=1671), and (3) assignment of health care proxy (n=1668), while controlling for demographic characteristics,. Samples were weighted. Analysis revealed that reporting more chronic conditions was associated with higher odds of advance directive completion (OR:1.21, p<.001), ACP engagement (OR: 1.26, p<.05), and assigning medical proxies (OR: 1.32, p<.001). However, better self-reported health was associated with higher odds of having an AD (OR: 1.20, p<.05) and assigning medical proxies (OR: 1.27, p<.01). These findings suggest that greater number of chronic conditions increased the odds of having an AD, engaging in ACP and in assigning medical proxies; however, those reporting better health were more likely to have an AD and a medical proxy. Findings from this study point suggest that individuals with multi-morbidities may be more open to engaging in ACP discussions and activities.

Factors related to advance care planning among older African American women: Age, medication, and acute care visits

2019 ◽  
Vol 18 (4) ◽  
pp. 413-418
Author(s):  
Jung Kwak ◽  
Julie L. Ellis
Keyword(s):  
African American ◽  
African American Women ◽  
Advance Care Planning ◽  
Chronic Conditions ◽  
Emergency Department Visits ◽  
Multiple Chronic Conditions ◽  
Care Planning ◽  
American Women ◽  
Older African American Women ◽  
Advance Care

AbstractObjectivesAdvance care planning (ACP) is linked with high-quality clinical outcomes at the end of life. However, ACP engagement is lower among African Americans than among Whites. In this study, we sought to identify correlates of ACP among African American women with multiple chronic conditions for two reasons: (1) African American women with multiple chronic conditions have high risks for serious illnesses, more intensive treatments, and circumstances that may require substitutes' decision-making and (2) identifying correlates of ACP among African American women can help us identify important characteristics to inform ACP outreach and interventions for this group.MethodsA cross-sectional survey was conducted with 116 African American women aged ≥50 years who were recruited from the central area of a mid-western city.ResultsOn average, participants were 64 years old (SD = 9.42). The majority were not married (78%), had less than a college education (50%), and had an annual income of $15,000 (54%). Their mean numbers of chronic conditions and prescribed medications were 3.31 (SD = 1.25) and 8.75 (SD = 4.42), respectively. Fifty-nine per cent reported having talked with someone about their preferences (informal ACP); only 30% had completed a living will or a power of attorney for healthcare (formal ACP). Logistic regression showed that age, the number of hospitalizations or emergency department visits, and the number of prescription medications were significantly correlated with both informal and formal ACP; other demographic and psychosocial characteristics (the knowledge of ACP, self-efficacy, and trust in the medical system) were not.Significance of resultsResults of this study suggest a need for targeted, culturally sensitive outpatient ACP education to promote ACP engagement in older African American women, taking into account age, the severity of chronic conditions, and levels of medication management.

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