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Factors Associated with Family Caregivers’ Intentions to Complete an Advance Directive for Individuals with Dementia: A Cross-Sectional Descriptive Study

Year: 2025

Type: article

Abstract: Background/Objectives: As dementia progresses, patients often lose decision-making capacity, leaving family members responsible for making critical end-of-life (EOL) care decisions. This cross-sectional descriptive study explored the factors associated with the intention to complete an advance directive (AD) among family caregivers of older adults with dementia in South Korea. Methods: This study surveyed 140 caregivers aged 20 years or older to assess their knowledge of advance directives (ADs), preferences for EOL care, and attitudes toward withdrawing life-sustaining treatment (LST). Data were collected from 1 August to 14 August 2024, and analyzed using descriptive statistics, the Chi-squared test, Fisher’s exact test, Spearman’s correlation, and logistic regression, with SPSS/WIN 28.0. Results: The intention to complete an AD significantly differed by religion (p = 0.004) and the functional status of the patient with dementia (p = 0.012). There was a positive correlation between intention to complete an AD and knowledge of ADs (r = 0.23, p = 0.007). Factors associated with intention to complete an AD included religion (OR = 4.36, p = 0.028) and knowledge of ADs (OR = 1.16, p = 0.033), explaining 22.2% of the variance, which is considered meaningful in studies dealing with complex psychosocial and behavioral variables. Conclusions: These findings suggest that religious affiliation and knowledge of ADs may contribute to greater emphasis on EOL preparedness and self-determination. To promote informed decision making, it is essential to implement targeted educational interventions—such as community-based workshops, telehealth counseling, and in-clinic guidance—that enhance caregivers’ understanding of ADs and empower them in their caregiving roles.

Source: Healthcare

DOI: 10.3390/healthcare13111297

Authors: Hyeseon Park, Sujin Kang, Youngji Kim

Institutions: Daejeon Sun Hospital, Catholic University of Korea, Kongju National University

Language: English

Topic: Palliative Care and End-of-Life Issues

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,258