As the proportion of the US population constituted by older adults increases dramatically over the next few decades, and life-sustaining medical treatments continue to proliferate, it is imperative that steps be taken to ensure that preferences for end-of-life care are recorded and respected. The completion of advance directives is the primary mechanism for doing so. Acknowledging appropriate ethical considerations, such advance preparation should be encouraged. Using a new, stages of change-based measure developed by the authors for the evaluation of the readiness of older adults to create advance directives, this project will consider the characteristics that determine one’s readiness to institute a directive. Pilot testing of the measure on a convenience sample of 177 older African Americans reveals that while 22% already have an advance directive, the remaining 138 range from having never thought about creating an advance directive (36%) to having already taken steps toward doing so (7%). Using a variety of analytical methods, this project first elucidates the determinants of one’s readiness to change. It then incorporates the acquired understanding of these determinants into suggestions for stage-appropriate, targeted interventions to encourage older adults to create advance directives. In addition, the intervention implications of the manner by which one conceptualizes the process driving an older adult’s decision to create an advance directive are described. Finally, this project considers the appropriateness of using a stage-based approach versus a critical event-based approach to advance directive creation.
Learning Objectives: To introduce a new stage-based approach to measuring the process by which advance directives are created
Keywords: Aging, End-of-Life Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: University of North Carolina Center on Minority Aging
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.