Advance Directives and End of Life Issues

Health Care providers who have discussions about advance directives and advance care planning should remember that the elders might be reluctant to participate in these discussions, as they may believe that talking about death may make it a reality. Sensitivity is called for when having these discussions. Ensure that you have adequate time and that patient’s family is present and a professional interpreter if possible.

Decisions and discussions regarding advanced directives are often difficult. Koreans, as with other ethnic groups often believe that discussing death in the presence of the ill family member will bring about sadness or depression. This often makes discussions regarding end of life and advanced directives difficult. However though discussions may be difficult to bring up it is important to inquire. One study looking at the relationship between ethnicity and advanced directives in a frail older population, Asians were more likely than whites to select less aggressive interventions but were unlikely to use written advanced directives. (Eleazer, GP et.al., 1996).