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Opiniones: end-of-life care preferences and planning of older Latinos

TitleOpiniones: end-of-life care preferences and planning of older Latinos
Publication TypeJournal Article
Year of Publication2010
AuthorsKelley, AS, Wenger, NS, Sarkisian, CA
JournalJ Am Geriatr SocJ Am Geriatr Soc
Volume58
Pagination1109-16
Date PublishedJun
ISBN Number1532-5415 (Electronic)<br/>0002-8614 (Linking)
Accession Number20487080
KeywordsAdvance Care Planning, Aged, Aged, 80 and Over, Attitude to Death, Chi-Square Distribution, Cross-Sectional Studies, Cultural Characteristics, Decision Making, Female, Hispanic Americans/ psychology, Humans, Interviews as Topic, Logistic Models, Los Angeles, Male, Middle Aged, Personal Autonomy, Quality of Life, Terminal Care/ psychology
AbstractOBJECTIVES: To measure end-of-life (EOL) care preferences and advance care planning (ACP) in older Latinos and to examine the relationship between culture-based attitudes and extent of ACP. DESIGN: Cross-sectional interview. SETTING: Twenty-two senior centers in greater Los Angeles. PARTICIPANTS: One hundred forty-seven Latinos aged 60 and older. MEASUREMENTS: EOL care preferences, extent of ACP, attitudes regarding patient autonomy, family-centered decision-making, trust in healthcare providers, and health and sociodemographic characteristics. RESULTS: If seriously ill, 84% of participants would prefer medical care focused on comfort rather than care focused on extending life, yet 47% had never discussed such preferences with their family or doctor, and 77% had no advance directive. Most participants favored family-centered decision making (64%) and limited patient autonomy (63%). Greater acculturation, education, and desire for autonomy were associated with having an advance directive (P-values <.03 controlling="" for="" sociodemographic="" characteristics="" greater="" acculturation="" odds="" ratio="" confidence="" interval="" and="" preferring="" autonomy="" ci="1.1-2.3)" were="" independently="" associated="" with="" having="" an="" advance="" directive.="" conclusions:="" the="" majority="" of="" older="" latinos="" studied="" preferred="" less-aggressive="" comfort-focused="" eol="" care="" yet="" few="" had="" documented="" or="" communicated="" this="" preference.="" discrepancy="" places="" at="" risk="" receiving="" high-intensity="" inconsistent="" their="" preferences.="">