Abstract
IntroductionAdvanced directives enable the planning of care and support services independent of the older person’s ability to make the decision. There is a paucity of information regarding the views and preferences regarding advanced directives and other end of life issues among older persons in low and middle-income countries such as Nigeria. The study aimed to explore the knowledge, attitude and belief of older persons regarding decision making surrounding end of life and advance directivesMethodsData were collected through focus group discussions at a monthly social gathering of outpatients in a geriatric center in Oyo State, Nigeria. Discussions were audiotaped, transcribed and analyzed manually using a thematic approach.ResultsRespondents’ knowledge about the end of life care and advanced directives as prescribed in high income settings were sparse and did not include choices about treatment options or any medical directives. The predominant perceptions among the participants bordered mainly on the arrangements for place of death, burial and property sharing. Participants listed in order of preference the major decision makers in the advanced directive process mainly, the oldest male child, religious leaders and legal practitioners.ConclusionOur findings imply the need for improving knowledge and awareness about the benefits of advanced directives among older persons with a focus on opportunities for their active participation.
Highlights
Death and dying is a reality that every individual must face at one point or the other in life
There is a paucity of information on end of life issues including advanced directives among the older persons in many low and middle-income countries (LMIC) including Nigeria
This study was conducted at the Chief Tony Anenih Geriatric Centre (CTAGC), University College Hospital (UCH), Ibadan
Summary
Death and dying is a reality that every individual must face at one point or the other in life. Due to population aging many older persons are exceeding previous life expectancy and are expected to live more years in good health [2]. There is a paucity of information on end of life issues including advanced directives among the older persons in many low and middle-income countries (LMIC) including Nigeria. Advanced directives are “documented instructions by a patient to ensure their medical preferences are fulfilled in the event that they can no longer communicate with their clinicians or family members” [7]. End of life decision making include treatment options or preferences before death, designation of a power of attorney for health care and decisions regarding a living will [8]. Shows that advanced directives, when properly utilized, is associated with benefits including the promotion of patient autonomy and quality of life [7]
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