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Published on: September 30, 2020
Life-Stage and Contextual Factors of Advance Care Planning Among Older Adults With Limited Income
Christine C Kimpel1, Jana Lauderdale1, David G Schlundt2
1Vanderbilt University School of Nursing, Nashville, TN, USA.
Abstract:
Patient perspectives are essential to understand healthcare disparities such as low rates of advance care planning (ACP) among adults with limited income. We completed twenty semi-structured interviews using purposive and snowball sampling. Initial and final themes emerged from inductive inclusion of recurring codes and deductive application of the cumulative disadvantage theory. Four themes emerged: (1) structural, (2) life-stage, (3) social stressors and resources, and (4) individual stress responses and ACP readiness. ACP resources among participants included positive structural and social support and previous familial death experiences that were mitigated by stress avoidance and competing priorities. Structural resources and healthcare stressors should be addressed with policy and research to improve continuous healthcare participation and support early, comprehensive ACP.
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