Caregiving preferences and advance care planning among older adults living with HIV

AIDS Care ◽  
2018 ◽  
Vol 31 (2) ◽  
pp. 243-249 ◽  
Author(s):  
Annie L. Nguyen ◽  
David Seal ◽  
Omar Bruce ◽  
Margarida Dalton ◽  
Allison Palmer ◽  
...  
2021 ◽  
Vol 9 ◽  
Author(s):  
Annie L. Nguyen ◽  
Mariam Davtyan ◽  
Jeff Taylor ◽  
Christopher Christensen ◽  
Brandon Brown

Background: The importance of advance care planning (ACP) discussions have been heightened during the COVID-19 pandemic. We assessed advance directive completion, healthcare proxy (HCP), and attitudes toward ACP among older adults ages 50+ living with HIV during the COVID-19 pandemic.Methods: Internet-based surveys were administered to 100 participants residing in the Coachella Valley, California from April to June 2020. We examined self-reported completion of an advance directive, HCP, and attitudes toward ACP before and after COVID-19. Adjusted regressions were performed on attitudes toward ACP.Results: Participants' mean age was 64.2 years, most were non-Hispanic white (88.0%), men (96.0%), and identified as sexual minorities (96.0%). Many reported having an advance directive (59.6%) or HCP (67.3%). Most (57.6%) believed ACP to be more important now compared to the pre-pandemic era. Having an advance directive was associated with increase in age, higher education, living with other people, never having an AIDS diagnosis, and current undetectable viral load (p < 0.05). Having a HCP was associated with higher education, being married/partnered, and living with other people (p < 0.05). In a logistic regression model adjusted for education and living situation, the belief that ACP was more important during COVID was associated with not having an advance directive (OR: 5.07, 95% CI: 1.78–14.40) and fear of COVID-19 infection (OR: 4.17, 95% CI: 1.61–10.76.)Conclusions: The COVID-19 pandemic presents a window of opportunity to engage people aging with HIV in ACP discussions, particularly those who do not already have an advance directive.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 417-418
Author(s):  
Hyo Jung Lee ◽  
Giyeon Kim

Abstract Although there has been growing evidence that Advance care planning (ACP) benefits people with cognitive impairment nearing death, our understanding about this issue is still limited. This study examines whether cognitive impairment is associated with ACP engagement and end-of-life care preferences among older adults in the U.S. Using data from the 2012 National Health and Trends Study (n=1798, aged 65 to 101), we identified four levels of ACP engagement: None (28%), Informal ACP conversation only (12%), Formal ACP only (14%), and Both informal and formal ACP (46%). Older adults with None showed the highest prevalence of having cognitive impairment (17%), followed by those with Formal ACP only (15%) and the other two (6%, 6%). The results of Multinomial Logistic Regression showed that, compared to those without, respondents with cognitive impairment had 143% increased relative risk of having None (RR = 2.43, CI: 1.58-3.73) and 81% increased relative risk of completing Formal ACP only (RR = 1.81, CI: 1.11-2.95) relative to completing Both informal and formal ACP. In addition, respondents with None were more likely to prefer to receive all treatments available nearing death than those with any ACP engagement. Achieving high quality care at the end of life can be more challenging for older adults with cognitive impairment and their family caregivers due to the limited capacity. Although encouraged, informal ACP conversation with loved ones does not necessarily occur before the formal ACP, especially, for those with cognitive impairment. Therefore, they may merit more attention such as early ACP engagement.


Cancer ◽  
2021 ◽  
Author(s):  
Sarah S. Nouri ◽  
Deborah E. Barnes ◽  
Ying Shi ◽  
Aiesha M. Volow ◽  
Nikita Shirsat ◽  
...  

Author(s):  
Linda H. Phung ◽  
Deborah E. Barnes ◽  
Aiesha M. Volow ◽  
Brookelle H. Li ◽  
Nikita R. Shirsat ◽  
...  

2018 ◽  
Vol 178 (12) ◽  
pp. 1616 ◽  
Author(s):  
Rebecca L. Sudore ◽  
Dean Schillinger ◽  
Mary T. Katen ◽  
Ying Shi ◽  
W. John Boscardin ◽  
...  

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