End-of-life treatment preference among low-income older adults: a race/ethnicity comparison study

J Health Care Poor Underserved. 2014 Aug;25(3):1021-33. doi: 10.1353/hpu.2014.0129.

Abstract

Introduction: Racial/ethnic minority older adults in low-income status might be at a greater risk than others of developing chronic illness. We sought to examine the effects of race/ethnicity on end-of-life (EOL) treatment preference among low-income older adults.

Methods: A cross-sectional study surveyed 256 low-income older adults (90 Whites, 82 Hispanics, 84 Blacks) in a California city.

Results: Hierarchical multiple regression results showed that participants with greater religiosity (p < .01) or more frequent doctors' visits (p < .05) had greater preference for life-sustaining treatments during the final phase of life. Conversely, those with greater comfort about death (p < .01) or a belief that life and death are predestined (p < .05) preferred life-sustaining treatments less often. Race/ethnicity had no significant relationship with EOL treatment preference after accounting for other factors.

Conclusion: Race/ethnicity encompasses multiple life contexts. Understanding the influences of both cultural beliefs and individual circumstances on EOL treatment preference is imperative.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Attitude to Death
  • California
  • Cross-Sectional Studies
  • Female
  • Humans
  • Income*
  • Male
  • Patient Preference*
  • Racial Groups*
  • Religion
  • Surveys and Questionnaires
  • Terminal Care*