Abstract

To determine in a sample of older community-dwelling adults: (1) the proportion who have engaged in medical and financial planning; (2) the factors associated with advance care directive (ACD) completion and substitute decision maker (SDM) appointment; and (3) for those without an ACD, what might prompt completion. A cross-sectional survey was undertaken with individuals receiving community aged care services in metropolitan and regional communities. Data collection was conducted by case managers during a home visit. Overall, 158 individuals (M=78years, SD=8.7) participated (53.5% consent rate). Financial planning participation (will=85%; enduring power of attorney=66%) was higher than medical planning participation (SDM: 54%; ACD: 30%). No health status factors were significantly associated with ACD completion or SDM appointment. Diagnosis of a life-limiting illness was most likely to prompt ACD completion (77.6%). One third of older people residing in the community have completed an ACD. Strategies to improve uptake in this vulnerable population require further exploration.

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