Knowledge and Perceptions in Advance Care Planning

Abstract

Objective: This study explores detailed knowledge of medical terminology and connotations of equivocal phrases frequently used in advance care planning. Method: One hundred seventy community-dwelling older adults answered yes-or-no questions about their knowledge of medical conditions and treatments and completed a written questionnaire about their connotations of ambiguous phrases such as “live like a vegetable.” Results: On average, participants answered 78% of all factual questions correctly; however, accuracy ranged from 59% to 94% across individuals. Participants knew the most about basic treatment purposes and procedures and the least about treatment outcomes. Perceptions of equivocal phrases were idiosyncratic, even for conventional terms such as improvement. Discussion: Older adults approach advance care planning with critical misconceptions and individualistic perceptions, about which family and health care professionals may be unaware. Efforts to improve advance care planning should include instruction concerning medical information and encouragement to use explicit language to express treatment preferences.