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).

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