Factors Associated With Favorable Attitudes Toward End-of-Life Planning

Ruff, Heather; Jacobs, Robin J.; Fernández, M. Isabel; Bowen, G. Stephen; Gerber, Hilary

doi:10.1177/1049909110382770

Cited by 23 publications

(32 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Attitude toward hospice was not a significant predictor of intentions to use hospice in the multivariate model due to positive correlations of attitudes with knowledge, subjective norms, perceived control to use hospice, and preferences for EoLC. Other studies also found similar positive correlations between hospice attitudes and knowledge (Johnson et al, 2009;Ruff et al, 2011) and hospice attitudes and greater preferences for life-sustaining therapies (Johnson et al, 2008). In contrast to our findings, other studies reported that positive hospice attitudes in the general population were significantly associated with higher intentions to use hospice (Dussen et al, 2011;Park & Lee, 2012).…”

Section: Discussionsupporting

confidence: 77%

Planning Ahead: Using the Theory of Planned Behavior to Predict Older Adults’ Intentions to Use Hospice if Faced With Terminal Illness

et al. 2017

View full text Add to dashboard Cite

Hospice is underutilized in the United States, and many patients enroll for short periods of times. The purpose of this cross-sectional study was to identify significant predictors of intentions to use hospice in community-dwelling older adults. The Theory of Planned Behavior informed the selection of predictors. Data were collected from 146 White older adults ( M age = 69.5; 69% females). Multiple linear regression analyses showed that higher hospice knowledge, normative beliefs that support hospice utilization, higher perceived control to use hospice, and preferences for end-of-life care that favor comfort and quality of life over living as long as possible were significant predictors of intentions to use hospice. In spite of being a sample of mostly highly educated older adults, almost half did not know about funding for hospice. These results provide better understanding of where to focus interventions to educate older adults about hospice, ideally in advance of a crisis.

show abstract

Section: Discussionsupporting

confidence: 77%

Planning Ahead: Using the Theory of Planned Behavior to Predict Older Adults’ Intentions to Use Hospice if Faced With Terminal Illness

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Prior experiences with illness and medical decision‐making may be an important determinant in ACP and its perceived relevance to individuals. Several studies have examined the relationship between illness and end‐of‐life experiences and ACP, but findings have been contradictory …”

mentioning

confidence: 99%

Association of Experience with Illness and End‐of‐life Care with Advance Care Planning in Older Adults

Amjad

Towle

Fried

2014

J American Geriatrics Society

View full text Add to dashboard Cite

Objectives To examine whether experiences with illness and end-of-life care are associated with increased readiness to participate in advance care planning (ACP). Design Observational cohort study. Setting Community. Participants Persons age ≥ 60 recruited from physician offices and a senior center. Measurements Participants were asked about personal experience with major illness or surgery and experience with others’ end-of-life care, including whether they had made a medical decision for someone dying, knew someone who had a bad death due to too much/too little medical care, or experienced the death of a loved one who made end-of-life wishes known. Stages of change were assessed for specific ACP behaviors: completion of living will and healthcare proxy, communication with loved ones regarding life-sustaining treatments and quantity versus quality of life, and communication with physicians about these same topics. Stages of change included precontemplation, contemplation, preparation and action/maintenance corresponding to whether the participant was not ready to complete the behavior, was considering participation in the next six months, was planning participation within thirty days, or had already participated. Results Of 304 participants, 84% had one or more personal experiences or experience with others. Personal experiences were not associated with increased readiness for most ACP behaviors. In contrast, having one or more experiences with others was associated with increased readiness to complete a living will and healthcare proxy, discuss life-sustaining treatment with loved ones and discuss quantity versus quality of life with loved ones and with physicians. Conclusion Older individuals who have experience with end-of-life care for others demonstrate increased readiness to participate in ACP. Discussions with older patients regarding these experiences may be a useful tool in promoting ACP.

show abstract

“…As hypothesized, when the first spouse used hospice or had no ACP, the second spouse was more likely to engage in hospice or have no ACP. Results contribute to literature showing that married couples act similarly on a range of health behaviors, and literature showing that spouses are more likely to have ACP if their partner has engaged in ACP or their partner has died . We expand on our understanding of spousal concordance related to ACP and hospice use through 2 additional findings.…”

Section: Discussionmentioning

confidence: 95%

“…Results contribute to literature showing that married couples act similarly on a range of health behaviors, [11][12][13][14] and literature showing that spouses are more likely to have ACP if their partner has engaged in ACP 9,30 or their partner has died. [31][32][33][34][35] We expand on our understanding of spousal concordance related to ACP and hospice use through 2 additional findings. First, spouses who died first had approximately 10 percentage point lower rates of hospice use and ACP engagement than second spouses.…”

Section: Discussionmentioning

confidence: 97%

‘Til Death Do Us Part: End‐of‐Life Experiences of Married Couples in a Nationally Representative Survey

Kotwal

Abdoler

Diaz‐Ramirez

et al. 2018

J American Geriatrics Society

View full text Add to dashboard Cite

Background/Objectives: Among married couples, the death of one’s spouse can influence perceptions of health services available at the end-of-life (EOL). However, it is unknown if one spouse’s EOL experience is associated with the widowed spouse’s uptake of health services or advance care planning (ACP). We determine if EOL experiences in the first spouse are associated with EOL experiences in the second spouse. Design: Nationally-representative, longitudinal survey. Setting: Health and Retirement Study, Waves 1992–2012 linked to Medicare claims Participants: 4,558 community-dwelling older adults who died, representing 2,279 male-female married couples. Measurements: We examined three EOL experiences: 1) enrollment in hospice for >3 days before death; 2) lack of ACP prior to death; and 3) Intensive care unit (ICU) use during the last 30 days of life. We used multiple logistic regression to determine if the EOL experience of the first spouse was a significant predictor of the EOL experience in the second spouse after adjusting for demographics, socioeconomic status, health status, and time between the first and second spouses’ death. Results: First spouses who died were on average 80 years old and 62% male, and second spouses were on average 85 years old and 62% female. After adjustment, second spouses were more likely to use hospice if the first spouse used hospice services (OR=1.68, 95% CI: 1.29–2.20). Second spouses were less likely to have ACP when the first spouse did not have ACP prior to death (OR=2.91, 95% CI: 2.02–4.21). Hospice and ACP associations were stronger when deaths were closer in time to one another (p-value for interaction <0.05). Second spouses were more likely to use ICU services if the first spouse was in the ICU prior to death (OR=1.80, 95% CI: 1.27–2.55). Conclusions: The EOL experiences of older spouses are strongly associated, which may be relevant when framing ACP discussions.

show abstract

Factors Associated With Favorable Attitudes Toward End-of-Life Planning

Cited by 23 publications

References 31 publications

Planning Ahead: Using the Theory of Planned Behavior to Predict Older Adults’ Intentions to Use Hospice if Faced With Terminal Illness

Planning Ahead: Using the Theory of Planned Behavior to Predict Older Adults’ Intentions to Use Hospice if Faced With Terminal Illness

Association of Experience with Illness and End‐of‐life Care with Advance Care Planning in Older Adults

‘Til Death Do Us Part: End‐of‐Life Experiences of Married Couples in a Nationally Representative Survey

Contact Info

Product

Resources

About