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Predictors of advance directives among nursing home residents with dementia.
Int Psychogeriatr. 2018 03; 30(3):341-353.IP

Abstract

ABSTRACT

Background:

Advance directives are important for nursing home residents with dementia; for those with advanced dementia, surrogates determine medical decisions. However, in Taiwan, little is known about what influences the completion of these advance directives. The purpose of this study was to identify factors, which influence the presence of advance directives for nursing home residents with dementia in Taiwan.

METHOD

Our cross-sectional study analyzed a convenience sample of 143 nursing home dyads comprised of residents with dementia and family surrogates. Documentation of residents' advance directives, physical and cognitive status was obtained from medical charts. Surrogates completed the stress of end-of-life care decision scale and a questionnaire regarding their demographic characteristics. Nursing home characteristics were obtained from each chief administrator.

RESULTS

Less than half of the nursing home residents (39.2%) had advance directives and most (96.4%) had been completed by family surrogates. The following were predictors of an advance directive: surrogates had previously signed a do-not-resuscitate as a proxy and had been informed of advance directives by a healthcare provider; nursing homes had policies for advance directives and a religious affiliation.

CONCLUSIONS

Advance directives were uncommon for nursing home residents with dementia. Presence of an advance directive was associated with surrogate characteristics and the nursing home facilities; there was no association with characteristics of the nursing home resident. Our findings emphasize the need to develop policies and strategies, which ensure that all residents of nursing homes and their surrogates are aware of their right to an advance directive.

Authors+Show Affiliations

Department of Long-Term Care,College of Health Technology,National Taipei University of Nursing and Health Sciences,Taipei,Taiwan.School of Nursing,College of Medicine,Chang Gung University,Tao-Yuan,Taiwan.School of Nursing,College of Medicine,Chang Gung University,Tao-Yuan,Taiwan.School of Nursing,College of Medicine,Chang Gung University,Tao-Yuan,Taiwan.Department of Neurology,Chang Gung Memorial Hospital,Tao-Yuan,Taiwan.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28849756

Citation

Huang, Hsiu-Li, et al. "Predictors of Advance Directives Among Nursing Home Residents With Dementia." International Psychogeriatrics, vol. 30, no. 3, 2018, pp. 341-353.
Huang HL, Shyu YL, Weng LC, et al. Predictors of advance directives among nursing home residents with dementia. Int Psychogeriatr. 2018;30(3):341-353.
Huang, H. L., Shyu, Y. L., Weng, L. C., Chen, K. H., & Hsu, W. C. (2018). Predictors of advance directives among nursing home residents with dementia. International Psychogeriatrics, 30(3), 341-353. https://doi.org/10.1017/S1041610217001661
Huang HL, et al. Predictors of Advance Directives Among Nursing Home Residents With Dementia. Int Psychogeriatr. 2018;30(3):341-353. PubMed PMID: 28849756.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of advance directives among nursing home residents with dementia. AU - Huang,Hsiu-Li, AU - Shyu,Yea-Ing Lotus, AU - Weng,Li-Chueh, AU - Chen,Kang-Hua, AU - Hsu,Wen-Chuin, Y1 - 2017/08/29/ PY - 2017/8/30/pubmed PY - 2019/1/25/medline PY - 2017/8/30/entrez KW - cognitive impairment KW - dementia KW - nursing home KW - palliative care SP - 341 EP - 353 JF - International psychogeriatrics JO - Int Psychogeriatr VL - 30 IS - 3 N2 - : ABSTRACTBackground:Advance directives are important for nursing home residents with dementia; for those with advanced dementia, surrogates determine medical decisions. However, in Taiwan, little is known about what influences the completion of these advance directives. The purpose of this study was to identify factors, which influence the presence of advance directives for nursing home residents with dementia in Taiwan. METHOD: Our cross-sectional study analyzed a convenience sample of 143 nursing home dyads comprised of residents with dementia and family surrogates. Documentation of residents' advance directives, physical and cognitive status was obtained from medical charts. Surrogates completed the stress of end-of-life care decision scale and a questionnaire regarding their demographic characteristics. Nursing home characteristics were obtained from each chief administrator. RESULTS: Less than half of the nursing home residents (39.2%) had advance directives and most (96.4%) had been completed by family surrogates. The following were predictors of an advance directive: surrogates had previously signed a do-not-resuscitate as a proxy and had been informed of advance directives by a healthcare provider; nursing homes had policies for advance directives and a religious affiliation. CONCLUSIONS: Advance directives were uncommon for nursing home residents with dementia. Presence of an advance directive was associated with surrogate characteristics and the nursing home facilities; there was no association with characteristics of the nursing home resident. Our findings emphasize the need to develop policies and strategies, which ensure that all residents of nursing homes and their surrogates are aware of their right to an advance directive. SN - 1741-203X UR - https://www.unboundmedicine.com/medline/citation/28849756/Predictors_of_advance_directives_among_nursing_home_residents_with_dementia_ L2 - https://www.cambridge.org/core/product/identifier/S1041610217001661/type/journal_article DB - PRIME DP - Unbound Medicine ER -