Health Behaviour Research Collaborative, Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.
Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.
Australas J Ageing. 2021 Dec;40(4):373-380. doi: 10.1111/ajag.12927. Epub 2021 Mar 14.
To determine in a sample of older community-dwelling adults: (1) the proportion who have engaged in medical and financial planning; (2) the factors associated with advance care directive (ACD) completion and substitute decision maker (SDM) appointment; and (3) for those without an ACD, what might prompt completion.
A cross-sectional survey was undertaken with individuals receiving community aged care services in metropolitan and regional communities. Data collection was conducted by case managers during a home visit.
Overall, 158 individuals (M = 78 years, SD = 8.7) participated (53.5% consent rate). Financial planning participation (will = 85%; enduring power of attorney = 66%) was higher than medical planning participation (SDM: 54%; ACD: 30%). No health status factors were significantly associated with ACD completion or SDM appointment. Diagnosis of a life-limiting illness was most likely to prompt ACD completion (77.6%).
One third of older people residing in the community have completed an ACD. Strategies to improve uptake in this vulnerable population require further exploration.
在一个年龄较大的社区居住的成年人样本中确定：（1）参与医疗和财务规划的比例；（2）与预先护理指令（ACD）完成和替代决策人（SDM）任命相关的因素；以及（3）对于那些没有 ACD 的人，是什么促使他们完成 ACD。
对大都市和地区社区接受社区老年护理服务的个人进行了横断面调查。数据收集是由个案经理在家庭访问期间进行的。
共有 158 人（M = 78 岁，SD = 8.7）参与了研究（同意率为 53.5%）。财务规划的参与率（意愿书为 85%；持久授权书为 66%）高于医疗规划的参与率（SDM：54%；ACD：30%）。没有健康状况因素与 ACD 完成或 SDM 任命显著相关。诊断为绝症最有可能促使 ACD 完成（77.6%）。
三分之一居住在社区的老年人已完成 ACD。需要进一步探讨提高这一脆弱人群参与率的策略。
