Opiniones: end-of-life care preferences and planning of older Latinos

J Am Geriatr Soc. 2010 Jun;58(6):1109-16. doi: 10.1111/j.1532-5415.2010.02853.x. Epub 2010 May 7.

Abstract

Objectives: To measure end-of-life (EOL) care preferences and advance care planning (ACP) in older Latinos and to examine the relationship between culture-based attitudes and extent of ACP.

Design: Cross-sectional interview.

Setting: Twenty-two senior centers in greater Los Angeles.

Participants: One hundred forty-seven Latinos aged 60 and older.

Measurements: EOL care preferences, extent of ACP, attitudes regarding patient autonomy, family-centered decision-making, trust in healthcare providers, and health and sociodemographic characteristics.

Results: If seriously ill, 84% of participants would prefer medical care focused on comfort rather than care focused on extending life, yet 47% had never discussed such preferences with their family or doctor, and 77% had no advance directive. Most participants favored family-centered decision making (64%) and limited patient autonomy (63%). Greater acculturation, education, and desire for autonomy were associated with having an advance directive (P-values <.03). Controlling for sociodemographic characteristics, greater acculturation (adjusted odds ratio (AOR)=1.6, 95% confidence interval (CI)=1.1-2.4) and preferring greater autonomy (AOR=1.6, 95% CI=1.1-2.3) were independently associated with having an advance directive.

Conclusions: The majority of older Latinos studied preferred less-aggressive, comfort-focused EOL care, yet few had documented or communicated this preference. This discrepancy places older Latinos at risk of receiving high-intensity care inconsistent with their preferences.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Advance Care Planning*
  • Aged
  • Aged, 80 and over
  • Attitude to Death*
  • Chi-Square Distribution
  • Cross-Sectional Studies
  • Cultural Characteristics
  • Decision Making
  • Female
  • Hispanic Americans / psychology*
  • Humans
  • Interviews as Topic
  • Logistic Models
  • Los Angeles
  • Male
  • Middle Aged
  • Personal Autonomy
  • Quality of Life
  • Terminal Care / psychology*