Planning Ahead: Using the Theory of Planned Behavior to Predict Older Adults' Intentions to Use Hospice if Faced With Terminal Illness

J Appl Gerontol. 2019 Apr;38(4):572-591. doi: 10.1177/0733464817690678. Epub 2017 Feb 5.

Abstract

Hospice is underutilized in the United States, and many patients enroll for short periods of times. The purpose of this cross-sectional study was to identify significant predictors of intentions to use hospice in community-dwelling older adults. The Theory of Planned Behavior informed the selection of predictors. Data were collected from 146 White older adults ( M age = 69.5; 69% females). Multiple linear regression analyses showed that higher hospice knowledge, normative beliefs that support hospice utilization, higher perceived control to use hospice, and preferences for end-of-life care that favor comfort and quality of life over living as long as possible were significant predictors of intentions to use hospice. In spite of being a sample of mostly highly educated older adults, almost half did not know about funding for hospice. These results provide better understanding of where to focus interventions to educate older adults about hospice, ideally in advance of a crisis.

Keywords: Theory of Planned Behavior; hospice; intentions; older adults.

MeSH terms

  • Advance Directives / statistics & numerical data
  • Aged
  • Cross-Sectional Studies
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Hospice Care / psychology
  • Hospice Care / statistics & numerical data*
  • Humans
  • Linear Models
  • Male
  • Medicare
  • Middle Aged
  • Patient Preference / psychology
  • Patient Preference / statistics & numerical data*
  • Religion
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • United States
  • White People / psychology
  • White People / statistics & numerical data*