Completion of Advance Directives Among Low-Income Older Adults: Does Race/Ethnicity Matter?

Eunjeong Ko, Jaehoon Lee

Research output: Contribution to journalArticlepeer-review

51 Scopus citations


This study examined the prevalence of completion of advance directives (ADs) and the effects of race/ethnicity on AD completion using a cross-sectional design. Low-income older adults (n = 256) who were residents of supportive housing facilities or members of a senior center were interviewed in person. About 20% of the participants had completed ADs. Knowledge and attitudes toward ADs, income, and previous experience in an intensive care unit significantly predicted the completion of ADs after controlling for other factors. Those with higher levels of knowledge, positive attitudes, or those with higher incomes were more likely to complete ADs than their counterparts. Findings suggest that as a proxy for multiple socioeconomic, social and cultural factors, race, and ethnicity need to be considered in planning end-of-life care.

Original languageEnglish
Pages (from-to)247-253
Number of pages7
JournalAmerican Journal of Hospice and Palliative Medicine
Issue number3
StatePublished - May 2014


  • advance directives
  • cultural competence
  • end-of-life care
  • low income
  • older adults
  • race/ethnicity


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