Feasibility of Advance Care Planning in Primary Care for Homeless Adults

被引：7

作者：

Kaplan-Weisman, Laura ^{[1
,2
,3
]}

Sansone, Sara ^{[1
,4
,5
]}

Walter, Eve ^{[1
,2
]}

Crump, Casey ^{[1
,2
]}

机构：

[1] Inst Family Hlth, New York, NY USA

[2] Icahn Sch Med Mt Sinai, New York, NY 10029 USA

[3] Care Homeless, New York, NY USA

[4] Hunter Coll, New York, NY USA

[5] CUNY, Sch Grad Sch Publ Hlth & Hlth Policy, New York, NY 10021 USA

来源：

JOURNAL OF AGING AND HEALTH | 2020年 / 32卷 / 7-8期

关键词：

advance care planning; homeless; surrogateless; unbefriended; health care proxy; DIRECTIVE COMPLETION; DECISION-MAKING; PATIENT; END; INTERVENTION; MORTALITY;

D O I：

10.1177/0898264319862420

中图分类号：

R4 [临床医学]; R592 [老年病学];

学科分类号：

1002 ; 100203 ; 100602 ;

摘要：

Objectives: As the homeless population ages, it is imperative to improve access to advance care planning (ACP) and document preferences in case medical decision-making capacity is lost. Methods: We implemented an ACP Project to discuss and document advance care plans with all patients aged 45 and older who received primary care at our adult Homeless Program clinics. Results: Over 14 months, ACP was discussed with 48% (n = 138) of the population and health care proxy (HCP) appointment with 91% (n = 125) of these patients. Most (62%; n = 77) appointed a HCP from personal relationships, though a significant minority (38%; n = 48) could not and were considered "surrogateless." End-of-life preferences varied. Approximately 20% of patients wanted to defer to a surrogate for each decision. Discussion: ACP is feasible in primary care for adults who have experienced homelessness and should be incorporated into routine care.

引用

页码：880 / 891

页数：12

共 48 条

[1]

Aitken PV Jr, 1999, AM FAM PHYSICIAN, V59, P605

[2]

American Bar Association, 2015, BIFOCAL, V37, P43

[3] Mortality Among Homeless Adults in Boston Shifts in Causes of Death Over a 15-Year Period [J].