End-of-Life Plans for African American Older Adults With Dementia.

The study measured only one point in time, so it cannot show how end-of-life plans changed over the dementia trajectory. All information was self-reported by caregivers, and the researchers did not see the documents, so the reported possession of plans cannot be confirmed. The sample was small, convenience recruited, and mostly highly educated with higher reported income, so the high rates may not apply to less educated, lower-income, or non-African American families. PACE enrollees were included, and PACE programs actively promote advance care planning, which may have raised the rates. The study did not compare African American caregivers with any other group, so differences attributed to race or dementia cannot be established. It did not record what was inside written documents or what verbal wishes said, so it cannot show whether preferences were specific or followed.

The author(s) declared no potential conflicts of interest with respect to the research, authorship, or publication of this article.

Do not read the 63% written-document rate as evidence that most African American older adults with dementia generally have complete end-of-life plans. The sample was small, highly educated, self-reported, and many plans were only verbal or surrogate paperwork without recorded preferences.