Are older adults’ demographic characteristics social determinants of their perceived importance, desire, and ability to perform end-of-life self-care actions?

Background: Demographic characteristics play a role in influencing the decision to make end-of-life (EOL) directives among older adults living in the United States. Aims: To examine the associations between older adults’ demographic characteristics (age, sex, marital status, residential site, and educational level) and their perceived importance of four self-care actions for EOL planning, as well as their desire and ability to perform these actions. Settings: A cross-sectional survey study of community-dwelling adults living in the southern United States from 2015 to 2016. Participants: Community-dwelling adults aged 65 years and older (N = 123). Methods: A self-administered tool, the Patient Action Inventory for Self-Care and a demographic questionnaire were used. Multiple logistic regression was performed. Results: Forty-seven of (38.2%) participants lived in an urban community and 76 (61.8%) in a rural community. Demographic variables that were significant across the predictive models were older adults’ residence, education levels, age, and marital status. Four demographic characteristics of living in rural areas, without a high school education, being 75 years or older, and married could be social determinants of EOL planning. Conclusions: Older adults may need community-based support to address their end-of-life needs, especially those elders who want to remain independent in their home environment.