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Title: Association between region of birth and advance care planning documentation among older Australian migrant communities: A multi-center audit study.
Austin Authors: Sinclair, Craig;Sellars, Marcus ;Buck, Kimberly ;Detering, Karen M ;White, Ben P;Nolte, Linda 
Affiliation: School of Psychology, University of New South Wales, Sydney, Australia
Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
Neuroscience Research Australia (NeuRA), Sydney, Australia
Centre of Excellence in Population Ageing Research, University of New South Wales, Sydney, Australia
Australian Centre for Health Research Law, Faculty of Law, Queensland University of Technology, Brisbane, Australia
Advance Care Planning
Issue Date: 1-Jan-2021
Date: 2020-08-17
Publication information: The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences 2021; 76(1): 109-120
Abstract: This study explored associations between birth region, socio-demographic predictors and advance care planning (ACP) uptake. A prospective, multi-center, cross-sectional audit study of 100 sites across eight Australian jurisdictions. ACP documentation was audited in the health records of people aged 65 years or older accessing general practice (GP), hospital and long-term care facility (LTCF) settings. Advance care directives (ACD) completed by the person ('person completed ACDs') and ACP documents completed by a health professional or other person ('health professional or someone else ACP') were counted. Hierarchical multi-level logistic regression assessed associations with birth region. From 4187 audited records, 30.0% (1152/3839) were born outside Australia. 'Person completed ACDs' were less common among those born outside Australia (21.9% vs 28.9%, X2 (1, N = 3840) = 20.3, p & 0.001), while 'health professional or someone else ACP' was more common among those born outside Australia (46.4% vs 34.8%, X2 (1, N = 3840) = 45.5, p & 0.001). Strongest associations were found for those born in Southern Europe: 'person completed ACD' (OR = 0.56, 95% CI = 0.36-0.88), and 'health professional or someone else ACP' (OR = 1.41, 95% CI = 1.01-1.98). English-language proficiency and increased age significantly predicted both ACP outcomes. Region of birth is associated with the rate and type of ACP uptake for some older Australians. Approaches to ACP should facilitate access to interpreters and be sensitive to diverse preferences for individual and family involvement in ACP.
DOI: 10.1093/geronb/gbaa127
Journal: The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences
PubMed URL: 32803263
Type: Journal Article
Subjects: advance care directive
cultural and linguistic diversity
end-of-life care
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