چکیده (انگلیسی):

Background:With many information sources for healthy aging and life transitions, it is unknown whether
community-dwelling older adults desire physician involvement in future planning decisions. The study aimed
to examine older adults’ experiences and opinions concerning four future planning domains: advance care
planning, driving, finances, and housing.
Methods:Adults aged≥55 years living at a large urban, independent living facility were surveyed with an
anonymous, voluntary, paper-based, mailed questionnaire. Survey domains were advance care planning,
driving, finances, and housing. For each domain, questions assessed confidence, openness to discussions,
information sources, and prior and desired future role of the physician in decision-making by domain.
Comparisons across and within domains were determined using Chi-square tests.
Results:Theresponseratewas56%(N= 457; median age: 75 years; 74 % female). Among advance care
planning, driving, and finances, respondents weremore confident about whatit means to have an advance
directive (87 %, 95 % CI 84−90 %) than alternative transportation options (46 %, 95 % CI 42−51 %). Nearly
two-thirds of respondents (64 %, 95 % CI 59−68 %) were open to discussing driving cessation, though only
one-third (32 %, 95 % CI 28−37 %) were open to having a family member determine timing of driving
cessation. More individuals (44 %, 95 % CI 39−49 %) were open to a physician deciding about when to stop
driving. Past discussions with family or friends about advance care planning or finances were common,
although past discussions about driving were less common. Respondents reported personal experience and
family as key information sources, which were significantly more common than healthcare providers. While
prior involvement by physicians in decision-making was rare across all domains, some respondents expressed
desire for future physician involvement in all domains, with advance care planning (29 %, 95 % CI 25−33 %)
and driving safety (24 %, 95 % CI 20−28 %) having highest levels of support for future physician
involvement.
Conclusions:Some older adults desired more physician involvement in future planning for life transitions,
especially related to advance care planning and driving compared to finances and housing. Clinical
implications include increased patient-centered care and anticipatory guidance by physicians for aging-related
life transitions.