Awareness, approval and completion of advance directives in older adults in Switzerland.

Détails

ID Serval
serval:BIB_5A1B15F26AB7
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Awareness, approval and completion of advance directives in older adults in Switzerland.
Périodique
Swiss medical weekly
Auteur(s)
Vilpert S., Borrat-Besson C., Maurer J., Borasio G.D.
ISSN
1424-3997 (Electronic)
ISSN-L
0036-7672
Statut éditorial
Publié
Date de publication
16/07/2018
Peer-reviewed
Oui
Volume
148
Pages
w14642
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
Advance directives enable people to describe their preferences for medical treatment (living will) and/or to appoint a healthcare proxy who may decide on their behalf should they lose decision-making capacity. Advance directives are potentially important in determining the course of end-of-life care, as deaths are frequently preceded by end-of-life treatment decisions, which often require someone to make decisions on the patient's behalf. Switzerland introduced legally binding advance directives through its new child and adult protection law of 2013. But there is still no comprehensive evidence on older persons' awareness, attitudes and behaviours with regard to advance directives in Switzerland.
Our study aimed to assess levels of awareness, approval and completion of advance directives, as well as their respective associations with sociodemographic characteristics in the Swiss population aged 55 and older. Our study was cross-sectional and used data from the Survey of Health, Ageing and Retirement in Europe (SHARE), which included a special module on end-of-life issues in wave 6 (2015) in Switzerland (n = 2085).
Two years after the introduction of advance directives in Switzerland, 78.7% of adults aged 55 years and older had heard of them prior to the survey and 24% reported that they had completed one. Awareness of advance directives was higher in the German-speaking part of Switzerland (91%) than in the Italian- (57.1%) and French-speaking (43.3%) regions (p <0.001). Advance directive completion also differed significantly between the German- (28.7%), French- (10.3%) and Italian-speaking (17.9%) regions of Switzerland (p <0.001). Overall, 76.7% of Swiss adults aged 55 and older generally approved of advance directives, i.e., they either reported having already completed one or were planning to do so in the future. Of those who had not yet completed an advance directive, 32.9% believed that it was still "too early" for them to do so and 30.1% believed that they would not need one. Levels of awareness, approval and completion of advance directives also varied significantly by sex, age, education level and household composition.
Our results show some potential for improvement in levels of advance directive awareness and, especially, completion among older adults, notably in the French- and Italian-speaking Switzerland. In view of the generally high levels of approval of advance directives, our findings point to important barriers to their completion by older persons that should be addressed by policy makers in order to ensure an effective translation of individual intentions to complete an advance directive sometime in the future into concrete and timely actions toward this end.
Mots-clé
Advance Directives/legislation & jurisprudence, Advance Directives/psychology, Age Factors, Aged, Attitude to Death, Awareness, Cross-Sectional Studies, Decision Making, Female, Health Surveys, Humans, Male, Middle Aged, Sex Factors, Switzerland, Terminal Care/methods
Pubmed
Web of science
Open Access
Oui
Création de la notice
28/08/2018 15:46
Dernière modification de la notice
08/05/2019 19:01
Données d'usage