Clinical-sociodemographic characterization of older adults with chronic diseases and advance directives
Main Article Content
Keywords
Advance Directives, Aged, Chronic Disease, Palliative Care, Geriatrics
Abstract
Abstract
Background: Population aging has increased the prevalence of older adults with advanced non-oncological chronic diseases, who face complex end-of-life decisions. Advance directives support autonomy; however, their implementation remains limited.
Objective: To describe the clinical and sociodemographic characteristics of older adults with advanced non-oncological chronic diseases and with advance directives.
Material and methods: Observational, descriptive, cross-sectional, retrospective study carried out in the Geriatrics Department of the Hospital General de México “Dr. Eduardo Liceaga.” Records of patients ≥ 70 years in terminal or dying phases with signed advance directives (May 2023-June 2025) were reviewed; oncological disease was excluded. Descriptive and exploratory inferential analyses were performed using IBM SPSS, version 25.0.
Results: Out of 124 records, 89 met criteria. Mean age was 81.6 years; females predominated. Advance directives were mainly formalized during hospitalization and advanced deterioration. Decisions were mostly made by family members, mainly adult children. Limitation of therapeutic effort and symptom control predominated, with no significant associations.
Conclusions: Advance directives are established late, reflecting a reactive approach. Decision-making shows a homogeneous pattern toward comfort. Early implementation of advance directives should be promoted.
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