2 The Hampton Roads Messenger


Volume 10 Number 6


Advance Care Plans: African American Seniors and Life’s ‘What-Ifs’


hour shift,


BY SHERI L. STUART UPLAND, Calif.--In an eight-


evaluate the nursing care of a num- ber of patients admitted to Citrus Valley Hospital, here. They range from young to old. Some are rela- tively healthy. Others are critical. The busy surgical-care nurse re- viewer knows regardless of age, race or ethnicity, not every patient is prepared


Alicia Lamour will


important it is for people to be aware of the options they have if they become too sick to make decisions


“I cannot stress enough how for the


shown to ease unnecessary suffer- ing, improve quality of life, and pro- vide better understanding of the de- cision-making challenges facing the individual and his or her caregivers. Patients have the option of plac- ing an advance care health direc- tive form in their medical file. This is a legal document that lets patients have a say about how they want to be treated if they get very sick. “As a health care professional,


Lamour, who provided direct pa- tient care for 12 years before tran- sitioning to the administrative side of California’s health care system. Planning for life’s “what ifs” is


for themselves,” said


of life decisions,” added Lamour. For African Americans, Advance


Care Planning (ACP) has significant public health impact, yet it is met by multiple


I’ve educated many patients on this form and walked some through the process on various hospital admis- sions. This form will help guide health care professionals and loved ones on how to follow their wishes on life support treatments and end


Huang, PhD, a researcher from the University of Alabama at Birming- ham presented such findings in No- vember at the annual meeting of the Gerontological


barriers. Chao-Hui Sylvia


barriers to ACP, which she explained in her conference presentation, “Think- ing Ahead Project: A Pilot Interven- tion Study to Increase Acceptabil- ity of Advance Care Planning among


Huang’s research revealed three Society of America.


African American Middle-Aged and Older Adults.” These included lack of informed education, mistrust of doc- tors and avoidance of discussing death. In addition, Huang’s study found


unexpected.


most every adult needs to think about when they are healthy and still have decision-making pacity,”


said Huang. “Research over the years though has shown a very clear pattern of dispari- ties among African Americans.” Also known as a living will,


ca-


ACP rues are largely governed on a state-by-state basis. Californians can request assistance from a num- ber of agencies providing education and guidance on the ACP process. The Coalition for Compas-


sionate Care of California is one such organization that coordinates local


nurse practitioners and others. Medicare beneficiaries have no cost sharing the consulta- tion, if provided in conjunction with their


by physicians, some


that African Americans are less likely than non-Hispanic whites to engage in ACP due to the identified barriers. The study used a mixed-method of research to gather data through that included surveys and


with African Americans residing in the Deep South where racial disparities and health outcomes are most pronounced. “Advance


face-to-face important health care decision planning that is meetings


an al-


“I know I must do something, but my children have been hesitant to sit down and discuss end of life issues with me,” said Rena Neal, a 59-year-old of mother of four liv- ing in Southern California. “In the meantime, I’m working on getting this done through a legal service.” This article was written for In-


annual wellness visits.


land Valley News with support from a journalism fellowship awarded by New America Media and the Geron- tological Society of America, spon- sored by the Archstone Foundation.


to make conversations about ad- vance care planning and end of life a normal part of everyday life. Nationally, starting January 1, 2016, Medicare began cover- ing advance care planning con- sultations


coalitions across the state


February 2016


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