Baseline Knowledge Attitudes Satisfaction and Aspirations With Advance Care Planning: A Cross-Sectional Study

Area of Science:

• Gerontology
• Health Services Research
• Medical Ethics

Background:

• Advance Care Planning (ACP) adoption rates in the community are consistently low.
• Understanding patient perspectives on ACP is crucial for improving engagement.

Purpose of the Study:

• To evaluate patient knowledge, attitudes, satisfaction, and aspirations regarding Advance Care Planning.
• To explore factors influencing the adoption of Advance Care Planning among diverse patient groups.

Main Methods:

• Cross-sectional survey of Medicare and non-Medicare outpatients aged 65+ at a US teaching hospital.
• Questionnaires assessed awareness, readiness for written plans, surrogate decision-makers, and satisfaction with current arrangements.

Main Results:

• Medicare enrollees showed higher awareness of ACP than non-Medicare patients (100% vs. 43%).
• A significant majority were not ready to complete written ACPs (70% Medicare, 94% non-Medicare).
• Spouses and adult children were the most common surrogate decision-makers, with 41% satisfied with current arrangements.

Conclusions:

• Patients adapt ACP by informally using family to convey wishes, bypassing formal legal documents.
• Clinicians can enhance this informal system and improve visibility of treatment choices using digital tools.
• Addressing patient concerns and leveraging trusted relationships are key to successful ACP implementation.