Wellness in Sickness and Health (The W.I.S.H. Project): Advance Care Planning Preferences and Experiences Among Elderly Latino Patients

Wellness in Sickness and Health (The W.I.S.H. Project): Advance Care Planning Preferences and Experiences Among Elderly Latino Patients

Objective: To assess advance care planning (ACP) preferences, experiences, and comfort in discussing end-of-life (EOL) care among elderly Latinos. Methods: Patients aged 60 and older from the Los Angeles County and University of Southern California (LAC+USC) Medical Center Geriatrics Clinic (n = 41)...

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Published in:Clinical gerontologist Vol. 42; no. 3; pp. 259 - 266
Main Authors: Maldonado, Lauren Y, Goodson, Ruth B, Mulroy, Matthew C, Johnson, Emily M, Reilly, Jo M, Homeier, Diana C
Format: Journal Article
Language:English
Published: United States Routledge 27-05-2019
Taylor & Francis Ltd
Subjects:
Advance directives
Advance health care directive
Care plans
Chronic illnesses
Comfort
Counseling
Cultural competence
elderly
End of life decisions
Geriatrics
Health status
Hispanic/Latino
Latin American cultural groups
Medical conditions
medicine
Older people
palliative care
Patient communication
Patients
Polls & surveys
Primary care
Relatives
medicine
Hispanic/Latino
palliative care
elderly
Advance health care directive
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Summary:Objective: To assess advance care planning (ACP) preferences, experiences, and comfort in discussing end-of-life (EOL) care among elderly Latinos. Methods: Patients aged 60 and older from the Los Angeles County and University of Southern California (LAC+USC) Medical Center Geriatrics Clinic (n = 41) participated in this intervention. Trained staff conducted ACP counseling with participants in their preferred language, which included: (a) pre-counseling survey about demographics and EOL care attitudes, (b) discussion of ACP and optional completion of an advance directive (AD), and (c) post-session survey. Results: Patients were primarily Spanish speaking with an average of 2.7 chronic medical conditions. Most had not previously documented (95%) or discussed (76%) EOL wishes. Most were unaware they had control over their EOL treatment (61%), but valued learning about EOL options (83%). Post-counseling, 85% reported comfort discussing EOL goals compared to 66% pre-session, and 88% elected to complete an AD. Nearly half of patients reported a desire to discuss EOL wishes sooner. Conclusions: Elderly Latino patients are interested in ACP, given individualized, culturally competent counseling in their preferred language. Clinical Implications: Patients should be offered the opportunity to discuss and document EOL wishes at all primary care appointments, regardless of health status. Counseling should be completed in the patient's preferred language, using culturally competent materials, and with family members present if this is the patient's preference. Cultural-competency training for providers could enhance the impact of EOL discussions and improve ACP completion rates for Latino patients.
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ISSN:0731-7115
1545-2301
DOI:10.1080/07317115.2017.1389793