Although advance care planning (ACP) is associated with better care at the end of life, better quality of death, and less psychological distress in survivors, ethnic disparities in ACP completion rates have been documented and may be attributable to lack of knowledge about ACP or differences in cultural values and preferences. Despite rapid increases in the size of the Asian-American population, little is known about ACP preferences of Chinese Americans. The purpose of this study is to explore the knowledge, attitudes, and preferences of older Chinese Americans toward ACP. Focus groups with Chinese older adults (n = 34) were conducted in Mandarin, Cantonese, and English, and transcripts were analyzed using a grounded theory approach. Identified themes included knowledge and experience with ACP and end-of-life care options, health as a factor in timing of ACP and communication, and communication of end-of-life care preferences. Knowledge of and experience with ACP and end-of-life decision-making varied according to focus group, although few participants had an advance directive. Findings suggest that Chinese older adults prefer to use indirect communication strategies, such as commenting on the circumstances of others rather than directly stating their wishes, and informal contexts, such as during a family dinner rather than formal meeting, to convey their care preferences to loved ones and may employ similar tactics when communicating with clinicians. This is particularly important given the recent decision by the Centers for Medicare and Medicaid Services to provide reimbursement to physicians for engaging in advance care planning conversations.
Despite dramatic increases in hospice enrollment, ethnic disparities persist. With rapidly growing populations of Asian Americans, research is needed to elucidate factors that contribute to hospice underenrollment in subgroups of Asian populations. The purpose of this study was to explore older Chinese Americans' knowledge, understanding, and perceptions of hospice care. Three focus groups were conducted, one each in English, Mandarin, and Cantonese, all recruited from a Chinese social service agency. Focus groups were audiotaped and transcribed and then coded for themes. Thirty-four Chinese Americans participated in the groups, all but one reporting primary language other than English. Themes included lack of knowledge, death timing, burden (financial, emotional, physical toward family or government), peaceful death (relief of suffering), and quality of care (and its influence on perception of best care location). Findings indicate the need for hospice education and outreach to Chinese Americans. Additionally, to address concerns about burden and death in the home, efforts to improve access to hospice facilities are needed. Findings from this study provide direction for healthcare providers to address potential barriers to increasing access to hospice of Chinese Americans.
This is the first quantitative study to identify and characterize abuser subtypes. Tailored interventions are needed to reduce problem behaviors and enhance strengths specific to each abuser profile.
Elder mistreatment (EM) is a public health problem that harms millions of older Americans each year. Despite growing recognition of its occurrence, there are no evidence-based primary prevention programs. Although EM is distinct from other areas of family violence, including child maltreatment and intimate partner violence, common risk factors and theoretical underpinnings point to opportunities for prevention strategies. Drawing on evidence-based best practices found in other fields of family violence, we identify approaches that could be tested to prevent EM at the hands of family caregivers, who are among the most likely to commit mistreatment. Specifically, we examine home visiting approaches primarily used in the child maltreatment field and identify components that have potential to inform EM interventions, including prevention. We conclude that there is enough information to begin testing a prevention intervention for EM that targets caregivers.
PurposeOlder adults are common victims of assault, many of which may result in severe injuries. Yet, circumstances surrounding assaults in this population haven’t been well-described. This study examines perpetrators and mechanisms of geriatric physical assault injuries treated at US Emergency Departments (EDs).MethodsWe conducted an analysis of assault injuries in patients aged ¥60 treated in EDs during 2006–2014 using the National Electronic Injury Surveillance System-All Injury Program, which collects data from a nationally representative stratified probability sample of US hospitals and includes a brief narrative about injury circumstances for each case. We examined narratives based on a pre-determined protocol.ResultsFrom 2006–2014, 7761 assault injury-related ED visits occurred in victims aged ≥60, representing an estimated 4 25 992 treated in U.S. EDs. 62% of assault victims were male. Victims had a mean age of 68. Perpetrator information was available for 53.3% of cases, mechanism information for 66.7%, and weapon information for 58.7%. The most common perpetrators were family (28.8% of cases with information) and strangers/robbers (27.7%). 57.6% of perpetrators were in a relationship with an expectation of trust with the victim, suggesting that assaults were physical elder abuse. The most common mechanisms of injury were beating with fists (31.6% of cases with information), striking with objects (27.3%), and fall during altercation (20.2%). Multiple mechanisms were present in 33.3%. Assailants most frequently used their body parts as weapons (75.8% of cases with information), with fists (32.4%) most common. 37.8% used objects, most frequently gun (4.8% shot and 2.4% used as blunt object) or knife (4.9%).ConclusionOur findings provide ideas about circumstances surrounding geriatric assault injuries. The majority of geriatric assault victims were suffering from physical elder abuse. Most perpetrators struck victims and used personal weapons. Further research is needed to better understand these assaults to develop prevention strategies.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.