Factors Associated with Advance Directives Documentation: A Nationwide Cross-Sectional Survey of Older Adults in Korea

Boram Kim, Jiyeon Choi and Ilhak Lee
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Boram Kim: Division of Health Policy, Bureau of Health Policy, Ministry of Health and Welfare, Sejong-si 30113, Korea
Jiyeon Choi: Division of Medical Law & Ethics, Department of Medical Humanities and Social Sciences, Yonsei University College of Medicine, Seoul 03722, Korea
Ilhak Lee: Division of Medical Law & Ethics, Department of Medical Humanities and Social Sciences, Yonsei University College of Medicine, Seoul 03722, Korea

IJERPH, 2022, vol. 19, issue 7, 1-13

Abstract: Advance directives (ADs) can support autonomy in making healthcare decisions and minimize unnecessary discomfort during the treatment process at the end of life (EOL). This study aimed to investigate the factors that influence AD documentation among community-dwelling older adults. We used data from the National Survey of Older Koreans which was conducted nationwide in 2020. Data from participants aged 65 years or older were extracted using stratified multistage cluster sampling and the survey was conducted through one-on-one interviews. A total of 9920 older adults were included in this study: 421 respondents (4.7%) claimed that they had prepared for AD. Multivariable logistic regression analysis showed that being 75 years or older, having higher educational attainment, higher income, having any chronic disease(s), being screened for dementia in the past, being against futile life-sustaining treatment, taking a lecture on death and being registered for organ donation were positively associated with AD. Furthermore, when health was rated as average, it was associated with reduced odds of AD documentation compared when health was rated as good. These results suggest that more targeted efforts are required to promote EOL discussions among older adults.

Keywords: advance directives; advance care planning; life-sustaining treatment; end-of-life care; older adults; Korean (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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