RT Journal Article
SR Electronic
T1 Advance Directive and POLST Documentation in Decedents With Dementia at a Memory Care Center
JF Neurology: Clinical Practice
FD Lippincott Williams & Wilkins
SP 14
OP 21
DO 10.1212/CPJ.0000000000001123
VO 12
IS 1
A1 Naasan, Georges
A1 Boyd, Nicole D.
A1 Harrison, Krista L.
A1 Garrett, Sarah B.
A1 D'Aguiar Rosa, Talita
A1 Pérez-Cerpa, Brenda
A1 McFarlane, Shamiel
A1 Miller, Bruce L.
A1 Ritchie, Christine S.
A1 ,
YR 2022
UL http://cp.neurology.org/content/12/1/14.abstract
AB Background and Objectives To determine the frequency of and challenges to documentation of advance care planning (ACP) in people with dementia, we conducted a chart review of 746 deceased patients seen at a tertiary memory care center between 2012 and 2017.Methods The rates of documented advance directives (ADs), Physician Order for Life-Sustaining Treatment (POLST), and Do Not Resuscitate (DNR) status were calculated from review of institutional electronic health records. Regression analysis was used to determine associations between ACP documentation and patient characteristics.Results At the time of death, approximately half of the patients had a documented AD and/or DNR status and 37% had a documented POLST; 30% of patients did not have any ACP documentation. Whereas most of the ADs were documented more than 5 years before time of death, POLST and DNR status were documented more frequently within 2 years of time of death. People who presented to clinic at a younger age and who primarily spoke English were more likely to have documented ADs. People living in zip codes with lower household incomes were 2–4.5 times less likely to have a POLST or DNR documentation.Discussion ACP is underutilized in people with dementia, even among those seen in a specialty memory care center. ACP should be introduced early on for people with dementia to ensure patients have a voice in their care.