Prevalence of Advance Directives Among Older Adults Admitted to Intensive Care Units and Requiring Mechanical Ventilation

被引:18
作者
Gamertsfelder, Elise M. [1 ]
Seaman, Jennifer Burgher [2 ]
Tate, Judith
Buddadhumaruk, Praewpannarai [3 ]
Happ, Mary Beth [4 ,5 ]
机构
[1] NW Mem Hosp, Emergency Dept, Chicago, IL 60611 USA
[2] Univ Pittsburgh, Sch Med, Dept Crit Care Med, Postdoctoral Crit Care Res, 607 Scaife Hall,3550 Terrace St, Pittsburgh, PA 15261 USA
[3] Univ Pittsburgh, Sch Med, Dept Crit Care Med, Pittsburgh, PA 15261 USA
[4] Ohio State Univ, Coll Nursing, Ctr Excellence Crit & Complex Care, Crit Care Res, Columbus, OH 43210 USA
[5] Ohio State Univ, Coll Nursing, Ctr Excellence Crit & Complex Care, Columbus, OH 43210 USA
来源
JOURNAL OF GERONTOLOGICAL NURSING | 2016年 / 42卷 / 04期
关键词
OF-LIFE; DECISION-MAKING; QUALITY; DISCUSSIONS; MORTALITY; OUTCOMES; DEATH;
D O I
10.3928/00989134-20151124-02
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Because older adults are at high risk for hospitalization and potential decisional incapacity, advance directives are important components of pre-hospital advanced care planning, as they document individual preferences for future medical care. The prevalence of pre-hospital advance directive completion in 450 critically ill older adults requiring mechanical ventilation from two Mid-Atlantic hospitals is described, and demographic and clinical predictors of pre-hospital advance directive completion are explored. The overall advance directive completion rate was 42.4%, with those in older age groups (75 to 84 years and 85 and older) having approximately two times the odds of completion. No significant differences in the likelihood of advance directive completion were noted by sex, race, or admitting diagnosis. The relatively low prevalence of advance directive completion among older adults with critical illness and high mortality rate (24%) suggest a need for greater awareness and education.
引用
收藏
页码:34 / 41
页数:8
相关论文
共 26 条
[1]   Disability among Elderly Survivors of Mechanical Ventilation [J].
Barnato, Amber E. ;
Albert, Steven M. ;
Angus, Derek C. ;
Lave, Judith R. ;
Degenholtz, Howard B. .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2011, 183 (08) :1037-1042
[2]  
Beauchamp TL., 2019, PRINCIPLES BIOMEDICA, V8th
[3]  
Beesley SJ, 2015, AM J RESP CRIT CARE, V191
[4]  
Centers for Disease Control and Prevention, 2013, PERS CAR NEEDS
[5]  
Centers for Medicare and Medicaid Services, 2015, PROP POL PAYM QUAL P
[6]   Long-term mortality and quality of life after prolonged mechanical ventilation [J].
Chelluri, L ;
Im, KA ;
Belle, SH ;
Schulz, R ;
Rotondi, AJ ;
Donahoe, MP ;
Sirio, CA ;
Mendelsohn, AB ;
Pinsky, MR .
CRITICAL CARE MEDICINE, 2004, 32 (01) :61-69
[7]   Differences in one-year health outcomes and resource utilization by definition of prolonged mechanical ventilation: a prospective cohort study [J].
Cox, Christopher E. ;
Carson, Shannon S. ;
Lindquist, Jennifer H. ;
Olsen, Maren K. ;
Govert, Joseph A. ;
Chelluri, Lakshmipathi .
CRITICAL CARE, 2007, 11 (01)
[8]   ADVANCE CARE PLANNING AS A PROCESS - STRUCTURING THE DISCUSSIONS IN PRACTICE [J].
EMANUEL, LL ;
DANIS, M ;
PEARLMAN, RA ;
SINGER, PA .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 1995, 43 (04) :440-446
[9]   Enough - The failure of the living will [J].
Fagerlin, A ;
Schneider, CE .
HASTINGS CENTER REPORT, 2004, 34 (02) :30-42
[10]   DEVELOPING A NEW METRIC FOR ADLS [J].
FINCH, M ;
KANE, RL ;
PHILP, I .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 1995, 43 (08) :877-884