TY - JOUR
T1 - The Compliance of End-of-Life Care Preferences Among Older Adults and Its Facilitators and Barriers
T2 - A Scoping Review
AU - Master, Jie Fu
AU - Wu, Bei
AU - Ni, Ping
AU - Mao, Jing
N1 - Funding Information:
This study was funded by the National Natural Science Foundation of China , (project grant number: 71904056 ).
Publisher Copyright:
© 2021 AMDA – The Society for Post-Acute and Long-Term Care Medicine
PY - 2021/11
Y1 - 2021/11
N2 - Objectives: To explore the compliance of end-of-life (EOL) care preferences, and the facilitators and barriers of promoting quality of EOL care among older adults. Design: A scoping review was used to identify key themes in the compliance of EOL care preferences among older adults. Setting and participants: Studies published between 2009 and 2020 were identified from the Medline and Cochrane libraries. Eligible articles containing components related to the compliance of EOL care preferences among older adults were selected. Measures: The eligible articles were thematically synthesized. Factors that affected the compliance of EOL care preferences among older adults were identified from the key components. Results: In total, 35 articles were included to identify the key components in the compliance of EOL care preferences: (1) supportive policy, (2) supportive environment, (3) cultural characteristics, (4) advance care planning (ACP), (5) the concordance of EOL care preferences between patients and surrogate decision makers, (6) prognosis awareness, and (7) patient's health status and the type of disease. Facilitators for the compliance of EOL care preferences included enactment of relevant policy, sufficient care institutions, the utilization of ACP, and poor health status. Barriers included lack of supportive policy, different culture, and low utilization of ACP. Conclusions/Implications: The compliance of EOL care preferences was low among older adults. The compliance of EOL care preferences can be improved through relevant policy development and the utilization of ACP.
AB - Objectives: To explore the compliance of end-of-life (EOL) care preferences, and the facilitators and barriers of promoting quality of EOL care among older adults. Design: A scoping review was used to identify key themes in the compliance of EOL care preferences among older adults. Setting and participants: Studies published between 2009 and 2020 were identified from the Medline and Cochrane libraries. Eligible articles containing components related to the compliance of EOL care preferences among older adults were selected. Measures: The eligible articles were thematically synthesized. Factors that affected the compliance of EOL care preferences among older adults were identified from the key components. Results: In total, 35 articles were included to identify the key components in the compliance of EOL care preferences: (1) supportive policy, (2) supportive environment, (3) cultural characteristics, (4) advance care planning (ACP), (5) the concordance of EOL care preferences between patients and surrogate decision makers, (6) prognosis awareness, and (7) patient's health status and the type of disease. Facilitators for the compliance of EOL care preferences included enactment of relevant policy, sufficient care institutions, the utilization of ACP, and poor health status. Barriers included lack of supportive policy, different culture, and low utilization of ACP. Conclusions/Implications: The compliance of EOL care preferences was low among older adults. The compliance of EOL care preferences can be improved through relevant policy development and the utilization of ACP.
KW - End-of-life care preferences
KW - barriers
KW - compliance
KW - facilitators
KW - life-sustaining treatment
KW - older adults
KW - place of death
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U2 - 10.1016/j.jamda.2021.05.007
DO - 10.1016/j.jamda.2021.05.007
M3 - Review article
C2 - 34087224
AN - SCOPUS:85107961970
SN - 1525-8610
VL - 22
SP - 2273-2280.e2
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 11
ER -