End-of-Life Planning Prior to Death Among People Living With HIV

Mona Abdo; Adam Ressler; Samantha MaWhinney; Catherine Jankowski; Steven C Johnson; Kristine M Erlandson

doi:10.1097/JNC.0000000000000162

End-of-Life Planning Prior to Death Among People Living With HIV

J Assoc Nurses AIDS Care. 2021 Jan-Feb;32(1):127-133. doi: 10.1097/JNC.0000000000000162.

Authors

Mona Abdo¹, Adam Ressler, Samantha MaWhinney, Catherine Jankowski, Steven C Johnson, Kristine M Erlandson

Affiliation

¹ Mona Abdo, MPH, is a Doctoral Student, Epidemiology Department, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA. Adam Ressler, MD, is an Infectious Diseases Fellow, Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA; and previously an Internal Medicine Resident, University of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA. Samantha MaWhinney, ScD, is a Professor, Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA. Catherine Jankowski, PhD, is an Associate Professor, College of Nursing, University of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA. Steven C. Johnson, MD, is a Professor, Department of Medicine, Division of Infectious Diseases, University of Colorado School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA. Kristine M. Erlandson, MD, MS, is an Associate Professor, Department of Medicine, Division of Infectious Diseases, University of Colorado School of Medicine and Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA.

Abstract

People with HIV (PWH) often experience social isolation, loss of friends or partners, and estranged family relationships, creating challenges in selecting medical decision makers or clarifying end-of-life wishes. Whether advanced directive (AD) completion rates or informal proxy or medical power assignment (MPOA) differ by ultimate cause of death is unknown. We conducted a retrospective study of deceased PWH from a single clinic to examine factors associated with AD completion (47%) or MPOA assignment (73%) prior to death. AD completers were older at death (54.3[10.9] vs. 50.3[11.1] years, p = .04) than non-completers, and cancer death was more prevalent (23[54%] vs. 9[22%], p = .014). Patients with an MPOA had lower CD4 count (48% vs. 21%) and greater prevalence of cancer death (48% vs. 15%), but were of similar age at death (51.9[11.2] vs. 52.9[11.2] years, p = .66). This research identifies target populations for AD or MPOA education and assistance.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Advance Care Planning*
Advance Directives*
Death
Decision Making*
HIV Infections / drug therapy
HIV Infections / mortality
HIV Infections / psychology*
Humans
Male

Abstract

Publication types

MeSH terms

Grants and funding