Individual, interpersonal, and health care factors associated with informal and formal advance care planning in a nationally-representative sample of midlife and older adults.
Daniel Siconolfi, Julia Bandini, Emily Chen
PMID 33573918WHAT IT FOUND
Talking to a provider about end-of-life wishes was strongly linked to having those conversations and completing legal documents.
Being appointed as someone else's health care decision-maker was the single strongest factor associated with formal planning.
Key findings
01Having a health care provider bring up advance care planning was associated with both informal discussions and formal documentation.
02Respondents who had been designated as a health care decision maker for someone else had the largest odds of engaging in both informal and formal advance care planning.
03Non-Hispanic Black adults had lower odds of engaging in both informal and formal advance care planning compared to White adults, even after adjusting for other factors.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study is cross-sectional, so it cannot prove that provider conversations cause patients to engage in advance care planning; patients who already planned ahead may be more likely to recall provider discussions. All data were self-reported and subject to social desirability bias. The survey was administered only in English, potentially excluding non-English speaking populations. The study did not assess the quality or content of the advance care planning conversations.
Declared interests
The authors declared no conflicts of interest. The study was supported by an NIH grant.
The easy way to misread this
Do not assume that simply having a provider mention advance care planning guarantees the patient will complete formal documentation. The study found an association, but many factors influence whether a conversation translates into legal action.