Rebecca L. Sudore|Isabel Cuervo|Lina Tieu|David Guzman|Lauren M. Kaplan|Margot Kushel
Advance Care Planning for Older Homeless?Experienced Adults: Results from the Health Outcomes of People Experiencing Homelessness in Older Middle Age Study
University of California, San Francisco|San Francisco General Hospital|San Francisco VA Medical Center|Cornell University|San Francisco General Hospital|University of California, San Francisco|San Francisco General Hospital|University of California, San Francisco|San Francisco General Hospital|University of California, San Francisco|San Francisco General Hospital|University of California, San Francisco
older homelessexperienced adults low engagement advance care planning acp despite high morbidity mortality conducted crosssectional analysis cohort 350 homelessexperienced adults aged 50 older oakland california assessed prevalence potential surrogate decisionmakers acp contemplation discussions acp documentation surrogate designation advance directives used multivariable logistic regression examine factors associated acp discussions documentation median age cohort 59 range 5282 752 male 821 black sixtyone percent reported potential surrogate 215 discussed acp 190 reported acp documentation multivariable models 1 5 confidants versus none adjusted odds ratio aor58 95 confidence interval ci17200 3 chronic conditions versus none aor23 95 ci0956 recent primary care visit aor21 95 ci1044 associated higher odds acp discussions additional 5 years homelessness aor07 95 ci0509 lower odds 1 5 confidants aor50 95 ci14175 black aor55 95 ci15195 adequate versus limited literacy aor70 95 ci15324 associated higher odds acp documentation illicit drug use aor03 95 ci0109 lower odds although majority older homelessexperienced adults potential surrogate discussed documented acp wishes odds greater larger social networks future interventions must customized individuals limited social networks address instability homelessness health literacy constraints safetynet healthcare settings