Previous research has shown that care experiences influence the willingness for advance care planning (ACP). Family caregivers have increased contact with medical providers and procedures in the process of caring, and they have also witnessed the disability and suffering of patients. However, few studies have focused on family caregivers to understand their attitudes towards ACP. The aim of this cross-sectional study was to acknowledge family caregivers’ attitudes towards ACP and the related factors, especially care stress and experiences during the care process. We interviewed 291 family caregivers, and the demographics of the caregivers and care recipients, the clinical condition of care recipients, and the caregivers’ stress and care experiences were collected via anonymous questionnaires. Multiple logistic regression was performed to determine the factors associated with the attitudes towards ACP. We found that the caregiver having private health insurance (p < 0.001) and a completed DNR (p < 0.001) and the experience of recipients admitted to the ICU (p = 0.019) are associated with caregiver’s positive attitudes towards ACP. The greater the stress of conflict within a family over care decisions, the more participants think that ACP is important (p = 0.011). It is suggested that (1) in a family-centered culture, a public strategy for promoting ACP could be to emphasize the benefits of ACP in reducing family conflicts, and (2) when people make financial plans, they should also be provided with information about ACP to enable them to form a more integral plan for their future.

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Advance care planning (ACP) and advance directives (ADs) ensure patient autonomy in end-of life care. The number of ADs made and followed in Taiwan is still lacking. This study aimed to determine the factors that influence the willingness to participate in ACP among outpatients in Taiwan. In this study, we conducted a cross-sectional survey based on convenient sampling methods. The questionnaire included questions about participants’ basic sociodemographic information, knowledge of ACP, and awareness of ACP. A total of 198 adults who were outpatients of a family medicine clinic in an affiliated hospital in Taiwan were recruited. The associations between each variable were evaluated using the χ2 test. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using the logistic regression method to examine the influence of each variable on willingness to participate in ACP. Being happy and being a healthcare professional were positively correlated with ACP participation. A lack of ACP knowledge (OR = 0.30 in model A and OR = 0.42 in model C), valuing “Reducing families’ end-of-life decision-making burden” (OR = 2.53 in model B and OR = 2.65 in model C), and a “Belief in a good death” (OR = 4.02 in model B and OR = 4.10 in Model C) were the main factors affecting subjects’ willingness to participate in ACP. Knowing which factors influence willingness to participate in ACP helps in the promotion of ACP. Continuously educating both the general public and healthcare professionals strengthens knowledge about the right to autonomy, about its associated laws, and about the ACP process, and thus, programs should be created to provide this education. Additionally, taking into account the differences between cultures can be helpful.

Background SARS-CoV-2 led to the 2019 coronavirus outbreak (COVID-19) and recently became a pandemic infection. COVID-19’s disease mortality rates range from 1% to above 5% across many countries and are still rising. Patients receiving palliative care are the most fragile patient group. Palliative care employees treat terminal patients in the hospital, and go into the community to conduct in-home palliative care service. Because palliative care medical staff need to work between the hospital and community every day, they have become a high-risk group for COVID-19 infection. Methods We need a comprehensive care strategy to avoid COVID-19 cross-infection, and protect patients, medical staff, and family members. We divided participants into hospital care and palliative home care to discuss the different strategies. We will use the strengths, weaknesses, opportunities, and threats (SWOT) to analyze preventive strategies. Results We formulated different strategies, mainly by grading and triage, to avoid contact with high-risk latent infections, and used cleaning, disinfection, and personal protective equipment to block possible transmission. Although strict preventive measures had strengths to stop community outbreaks, there are many threats to providing effective palliative care. Conclusions Facing the severe global COVID-19 epidemic, we must have strict strategies to protect our patient and medical staff. But we need to obtain balance between epidemic prevention and palliative care. Preventing the ill patients from feeling lonely or abandoned is also important.