Pleschberger Sabine, Wosko Paulina
Zentrum für Public Health, Medizinische Universität Wien, Kinderspitalgasse 15/1, 1090, Wien, Österreich.
Gesundheit Österreich GmbH, Stubenring 6, 1010, Wien, Österreich.
Z Gerontol Geriatr. 2025 Mar 7. doi: 10.1007/s00391-025-02414-8.
Despite there is evidence for the need for advance care planning for older people living alone (OPLA), especially if they want to stay at home until the end, utilization of measures for ACP remains rather scarce. The causes for this discrepancy have not yet been researched in this target group.
Aim of this study was to get insight into the perspectives of OPLA in the community on planning ahead for the end of life.
(Secondary) Analysis of 26 qualitative interviews. 17 were from the Austrian Survey on the very old (ÖIHS), and 9 additional interviews were conducted with a specific focus on advance care planning to enrich the data base. Verbatim transcripts were analysed by applying coding procedures.
Not all people had specific concerns or a desire to deal with the end of life. In contrast to others, concerns about avoiding (unnecessary) life-prolonging measures resulted in a formal regulation, usually a living will. Staying at home or issues regarding burial and inheritance were often equally important concerns for OPLA. Numerous obstacles to formal arrangements were identified.
The heterogeneity of OPLA with regard to their willingness and form of planning ahead for staying at home shows the limits of standardized procedures. Comprehensive approaches to advance care planning that go beyond health issues are needed to meet the concerns of OPLA in the community.
尽管有证据表明独居老年人（OPLA）需要进行预先护理计划，特别是如果他们希望在家中安度晚年，但预先护理计划措施的使用仍然相当稀少。这一目标群体中这种差异的原因尚未得到研究。
本研究的目的是深入了解社区中独居老年人对临终规划的看法。
对26次定性访谈进行（二次）分析。17次访谈来自奥地利高龄老人调查（ÖIHS），另外9次访谈专门围绕预先护理计划进行，以丰富数据库。通过应用编码程序对逐字记录进行分析。
并非所有人都有特定的担忧或处理临终问题的愿望。与其他人不同，对避免（不必要的）延长生命措施的担忧导致了一项正式规定，通常是生前遗嘱。对独居老年人来说，在家养老或与丧葬和遗产有关的问题往往同样重要。确定了正式安排存在的诸多障碍。
独居老年人在居家养老预先规划的意愿和形式方面存在异质性，这表明标准化程序存在局限性。需要采取超越健康问题的全面预先护理计划方法，以满足社区中独居老年人的关切。
