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Using the Age-Friendly Environment Framework to Assess Advance Care Planning Factors Among Older Adults With Limited
Christine Cleary Kimpel1, Mary S Dietrich1,2, Jana Lauderdale1
1School of Nursing, Vanderbilt University, Nashville, Tennessee, USA.
The Gerontologist
|May 30, 2024
Summary
The Age-Friendly Environment framework may influence advance care planning (ACP) in older adults. Community factors like travel and social access correlate with quality-of-life discussions and healthcare decision-makers.
Area of Science:
- Gerontology
- Public Health
- Sociology
Background:
- The World Health Organization's Age-Friendly Environment (AFE) framework aims to foster healthy aging and equitable decision-making in communities.
- Socioeconomic disparities may impact advance care planning (ACP) participation among older adults.
- Understanding the link between community environment and ACP is crucial for health equity.
Purpose of the Study:
- To describe and examine the associations between Age-Friendly Environment (AFE) factors and advance care planning (ACP) among older adults with limited incomes.
- To investigate how community resources and accessibility influence end-of-life care discussions and decision-making.
Main Methods:
- Cross-sectional surveys were conducted with 100 older adults with limited incomes in Nashville, TN.
- Advance care planning (ACP) and Age-Friendly Environment (AFE) scales were dichotomized.
- Unadjusted phi correlation coefficients were used to analyze associations.
Main Results:
- A majority of participants found their community age-friendly (≥58%), with varied ACP participation (22%-67%).
- Perceived ease of travel, service access, and social isolation outreach were linked to quality-of-life discussions (phi=0.22-0.29, p<0.05).
- Having a healthcare decision-maker was associated with age-friendly travel, housing, and social spaces (phi=0.20-0.26, p<0.05).
Conclusions:
- The AFE framework provides a valuable lens for exploring environmental influences on ACP.
- Further research is needed to identify specific resources supporting ACP in socioeconomically disadvantaged populations.
- Community design and accessibility play a role in facilitating advance care planning for older adults.
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