Factors Influencing Older Adults' End-of-Life Care Preferences

Abstract

The objective of this study was to explore factors influencing Taiwanese older adults' end-of-life (EOL) care preferences. A cross-sectional questionnaire survey was conducted in 2 geriatric wards of a veterans' hospital. Fifty-five older adults aged 65 years or older were included. Structured questionnaires were used to collect data regarding demographic characteristics, EOL care preferences, stages of change for advance care planning behaviors, and reluctance to burden others. The study revealed that nearly 60% of the participants preferred to let their spouses, adult children, or health care professionals make the decisions. Furthermore, 83.6% of the participants lived with their family members and were moderately to severely disabled with a certain degree of dependence on their family members. Sex, independence, discussion of advance care planning with family members, and completion of advance directives were significantly correlated with EOL care preferences. The regression model showed that the participants' discussion of advance care planning with their family members influenced their EOL care preferences. The results demonstrate that family is an essential consideration for older adults choosing EOL care. Accordingly, because Chinese culture focuses on family harmony, improving communication between older adults and their family members is crucial for promoting advance care planning.

Taiwanese Older Adults Prefer to Use Antibiotics and Intravenous Infusion at the End of Life based on a Cartoon Version of the Life Support Preferences Questionnaire

“…Gender differs significantly in end-of-life treatment preferences, and men seem to favor end-of-life treatments, similar to previous studies [ 30 , 31 , 32 , 33 ]. A study in Switzerland showed that women tend to avoid over-treatment compared with men, and pay more attention to end-of-life planning [ 31 ].…”

Stability of End-of-Life Care Wishes and Gender-Specific Characteristics of Outpatients with Advanced Cancer under Palliative Therapy: A Prospective Observational Study

“…Perkins et al [ 27 ] reported that men tend to expect harm from the system, while women rather anticipated benefit. Ke et al [ 28 ] found that sex correlates with the EoL preferences in older hospitalized patients ( n = 55) in Taiwan. In a more recent trial, 186 cancer patients were asked about their preferences for EoL discussions.…”

Older Adults' Behavioral Intentions Toward Advance Care Planning Based on Theory of Reasoned Action

“…5 Factors affecting an older adult's decision to engage in ACP include age, sex, education level, health status, religious beliefs, knowledge of ACP, personal medical experience, communication with family members, support from family members, medical resources, and cultural sentiments. 3,[6][7][8][9][10][11][12][13][14] A mixed study on older adults with chronic diseases discovered that quality of life, family support, past medical experience, and attitude toward death affected their likelihood of implementing ACP. 15 Another survey study found that the desire among older adults to reduce the burdens of surrogate decision making and older adults' negative experiences with end-of-life care were motivators for ACP.…”