Advanced Care Planning in Refugee Patients

Area of Science:

• Public Health
• Geriatrics
• Sociology

Background:

• Advance care planning (ACP) is crucial for end-of-life care but underutilized in the US.
• Rates of ACP completion are lower in minority populations, with no data on refugees.
• Refugee populations face unique challenges in accessing and understanding healthcare directives.

Purpose of the Study:

• To determine the prevalence of advance care planning (ACP) documents among refugees resettled in the US.
• To assess refugee patients' awareness of and interest in ACP.
• To inform healthcare providers about the need for ACP discussions with refugee patients.

Main Methods:

• A survey was conducted with 28 refugee patients from diverse origins receiving primary care.
• Participants were asked about their awareness and possession of ACP documents (living wills, medical power of attorney).
• After explanation, interest in discussing ACP with physicians was assessed.

Main Results:

• Only 21.4% of refugees had heard of ACP, and merely 3.6% had prepared any ACP documents.
• A significant majority (78.5%) expressed interest in discussing ACP with their healthcare providers.
• This indicates a substantial gap in ACP knowledge and completion within this population.

Conclusions:

• Refugee populations exhibit very low rates of advance care planning (ACP) document completion.
• Clinicians are increasingly likely to encounter refugee patients and should proactively initiate ACP discussions.
• Addressing ACP needs in refugees is essential for culturally sensitive and comprehensive end-of-life care.