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Too Few Seniors Addressing Advance Care Planning

Finding suggests efforts to encourage more planning aren't working, researcher says

hand of elderly patient

MONDAY, Oct. 31, 2016 (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, Ph.D., a geriatrics research fellow at the University of California, San Francisco, and colleagues looked at 2,105 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 percent of the beneficiaries said they'd had discussions on end-of-life care, 49.7 percent on power of attorney, and 52.4 percent on other advance directives. Furthermore, 37.5 percent reported discussions on all three elements of advance care planning, while 27.3 percent said they hadn't discussed any of the elements.

The rate of discussions on each element varied by as much as 35 percent, depending on patient characteristics. For two 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 percent reporting end-of-life discussion, 20.0 percent discussing power of attorney, and 17.0 percent discussing advance directives. The study also found that older adults with dementia had much lower rates of end-of-life discussions (53.9 percent) and advance directives (46.4 percent) than those without dementia (62.1 and 53.5 percent, respectively).

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