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Advanced Care Planning in Commuinty Dwelling Older Adults
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There is a growing number of older Americans. This means an increased proportion of people at the end of life. Advanced care planning is significant because it has been shown to decrease costs at the end of life and increased quality of life (Sabino, 2010). Advanced directives such as living wills and durable power of attorney for health care have been used as markers of advance care planning but rates are generally low. The purpose of this cross-sectional study was to identify the rates of different types of advanced care planning completed by community dwelling older adults including advanced directives and determine if relationships exist between age, sex, health and primary care provider type and completion or discussion of advanced directives. Participants were recruited via convenience and/or snowball sampling from three local communities that provide programs for those over 50. Survey data was analyzed using logistics regression to test associations with level of significance set at < or = 0.05. A total of 177 surveys were collected. Rates of advance directive completion for this survey mirrored those of the national average (Predit, 2014). Many people have spoken to their family about advanced care planning (66.7%, n = 118) but doctors were not in the top four responses (19%, n = 35). Those conversations that did occur with the primary care provider were mainly started by the patient (54.3%, n = 19) and tended to last less than 5 minutes (42.9%, n = 15). The data also found a correlation between those who have not talked to anyone about advanced care planning and those who were not married (OR = 352.5, p < 0.0001). Further it found that men were less likely to talk with friends (OR = 0.341, p = 0.015) and family (OR = 0.298, p = 0.0009) about advanced care planning. This study gives important insight into advance care planning discussions and reveals those individuals who are less likely to complete advance care planning discussions