Older persons’ perceptions about advanced directives and end of life issues in a geriatric care setting in Southwestern Nigeria

Abstract

Introduction Advanced directives enable the planning of care and support services independent of the older person’s ability to make the decision. There is a paucity of information regarding the views and preferences regarding advanced directives and other end of life issues among older persons in low and middle-income countries such as Nigeria. The study aimed to explore the knowledge, attitude and belief of older persons regarding decision making surrounding end of life and advance directives Methods Data were collected through focus group discussions at a monthly social gathering of outpatients in a geriatric center in Oyo State, Nigeria. Discussions were audiotaped, transcribed and analyzed manually using a thematic approach. Results Respondents’ knowledge about the end of life care and advanced directives as prescribed in high income settings were sparse and did not include choices about treatment options or any medical directives. The predominant perceptions among the participants bordered mainly on the arrangements for place of death, burial and property sharing. Participants listed in order of preference the major decision makers in the advanced directive process mainly, the oldest male child, religious leaders and legal practitioners. Conclusion Our findings imply the need for improving knowledge and awareness about the benefits of advanced directives among older persons with a focus on opportunities for their active participation.

Perspective on advanced directives among older adults in Shanghai: A qualitative study

“…Peaceful and quality sunset life rather than excessive medical treatment (especially life-supporting equipment) was their choice. Foreign studies demonstrated a similar finding [ [50] , [51] , [52] ]. Domestic studies also indicated that older adults were not evasive about dying [ [53] , [54] , [55] ].…”

Ageing in place or stuck in place: Preferred care setting for community-dwelling older persons in a low-resource country in Sub Saharan Africa

“…In many instances, after migrating to the urban area to work and spend their productive years, many older persons return to their villages, where they prefer to die in the hands of their loved ones. Also, if they die outside their homes, they often leave advanced directives, which likely stipulate that their remains should be buried in their towns of origin [ 58 , 59 ]. Another explanation for the finding may be the increased social participation and intergenerational living arrangement in the rural area compared with the urban setting.…”

Perceptions, Attitudes, and Knowledge toward Advance Directives: A Scoping Review

“…In general, perceptions of ADs are positive. However, it should be noted that in countries without a defined legal framework for AD participants had lower perceptions of the subject in their studies [43,47,50,51]. Some of the studies revealed that between 82.2% and 86.6% of the participants had never heard of ADs [43,47], and there was also a study in which only 5.2% of the sample showed awareness of ADs [51].…”

“…Most of the articles 53.8% (n = 7) [41][42][43][44][45][46][47] described investigations in people with pathologies; 30.7% (n = 4) in the elderly and young adult population [12,[48][49][50]; and 15.3% (n = 2) focused on the general population [15,51].…”