Perspective on advanced directives among older adults in Shanghai: A qualitative study

Abstract

Objective: This study aimed to explore the perception on advanced directives (ADs) among older adults in Shanghai. Methods: Through purposive sampling, 15 older adults with rich life experiences who were willing to share perceptions and experiences of ADs participated in this study. Face-to-face semi-structured interviews were conducted to collect the qualitative data. Thematic content analysis was applied to analyze the data. Results: Five themes have been identified: low awareness but high acceptance of ADs; pursuing natural and peaceful sunset life; ambiguous attitude on medical autonomy; being irrational facing patients’ dying and death issues; positive about implementing ADs in China. Conclusion: It is possible and feasible to implement ADs in older adults. Death education and compromised medical autonomy may be needed in the Chinese context as the foundation. The elder’s understanding, willingness and worries about ADs should be fully revealed. Diverse approaches should be applied to introduce and interpret ADs to older adults continuously.

Keywords

• Advanced care planning
• Advanced directives
• Aged
• China
• Living will
• Qualitative research