Too Few Seniors Planning End-of-Life Care

HealthDay News — More than one-quarter of American seniors have never discussed end-of-life care, according to a research letter published online Oct. 31 in JAMA Internal Medicine.

Krista Harrison, PhD, a geriatrics research fellow at the University of California, San Francisco, and colleagues looked at 2105 Medicare beneficiaries aged 65 and older. Data from the group included self-reported age, gender, race/ethnicity, education, income, self-rated health, number of chronic conditions, disability in activities of daily living, and dementia.

The researchers found that 60.2% of the beneficiaries said they’d had discussions on end-of-life care, 49.7% on power of attorney, and 52.4% on other advance directives. Furthermore, 37.5% reported discussions on all 3 elements of advance care planning, while 27.3% said they hadn’t discussed any of the elements.

The rate of discussions on each element varied by as much as 35% , depending on patient characteristics. For 2 or more elements, the rate was lower among those aged 65 to 74, blacks, and Hispanics, and those with less education and lower income. The lowest rate of end-of-life planning was among older Spanish-speaking Hispanics, with 19.0% reporting end-of-life discussion, 20.0% discussing power of attorney, and 17.0% discussing advance directives. The study also found that older adults with dementia had much lower rates of end-of-life discussions (53.9%) and advance directives (46.4%) than those without dementia (62.1% and 53.5%, respectively).

Reference

Harrison KL, Adrion ER, Ritchie CS, et al. Low Completion and Disparities in Advance Care Planning Activities Among Older Medicare Beneficiaries. JAMA Intern Med. Published online October 31, 2016. doi:10.1001/jamainternmed.2016.6751.