Personal and Interpersonal Factors and Their Associations With Advance Care Planning Documentation: A Cross-Sectional Survey of Older Adults in Australia

Context: Personal and interpersonal factors may be influential in a person’s decision to engage in advance care planning (ACP), including completion of ACP documentation. Objectives: To conduct a cross-sectional survey of older adults accessing Australian general practices, hospitals and residential aged care facilities, with the aim of describing associations between personal factors and self-reported ACP documentation completion. Methods: Eligible participants included in a national health record audit were approached to complete a survey measuring demographic and health characteristics, preferences for care, worries about the future, and experiences talking with others about ACP and completing ACP documentation. Results: Of 1082 people eligible to participate in the survey, 507 completed the survey (response rate = 47%; median age 82 years) and 54% (n=272) reported having completed ACP documentation. Having ever discussed ACP with other people (anyone) or a doctor were both significant predictors of ACP documentation completion; whereas having previously spoken specifically to a partner about ACP, currently living with children compared to living alone and being aged 55-69 versus 90-99 years of age were associated with reduced odds of ACP documentation completion. Conclusions: Approximately half the participants reported having completed ACP documentation. The strongest predictor of ACP documentation completion was having spoken to anyone about ACP followed by having spoken to a doctor about ACP. These findings suggest that discussions about ACP are an important part of the process of completing ACP documentation.