Differences in Advance Care Planning Between American Indian and White Older Adults

Advance care planning (ACP) is understudied among American Indian individuals. A cross-sectional, self-administered survey was conducted with a convenience sample of 200 American Indian and 436 non-Hispanic White older adults from two Midwestern states to identify correlates of ACP. Compared with their White peers, American Indian older adults were significantly less likely to have an end-of-life (EOL) care plan or to have completed a durable power of attorney for health care (DPAHC) or a living will. Multivariate logistic regression showed that having an EOL plan was associated with older age, having some college education or more, and having a greater number of chronic conditions, but not with race. Having a DPAHC was associated with being White, older age, having lower levels of depressive symptoms, and having a greater number of chronic conditions, whereas completing a living will was associated with being White, older age, having some college education or more, and having a greater number of chronic conditions. Nurses need to engage in targeted culturally sensitive approaches to promote ACP, grounded in indigenous cultures' health beliefs and practices.