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Advance directives among Korean American older adults: knowledge, attitudes, and behavior
- Authors:
- KO Eunjeong, BERKMAN Cathy S.
- Journal article citation:
- Journal of Gerontological Social Work, 55(6), August 2012, pp.484-502.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This investigated knowledge, attitudes, and behaviour about advance directives and how cultural values influence these beliefs. Three focus groups with 23 older Korean American adults were conducted in the New York City area. Findings revealed that advance directives were seen as helpful for ensuring that preferences for unwanted end-of-life treatment were honoured and for relieving the decision-making burden on family members. However, some viewed completing advance directives as contrary to focusing on living. The authors concluded that culturally competent education about advance directives for Korean American older adults was necessary to help them make informed decisions about end-of-life care and informing family and health care providers of these preferences. Implications for practice are discussed.
Role of children in end-of-life treatment planning among Korean American older adults
- Authors:
- KO Eunjeong, BERKMAN Cathy S.
- Journal article citation:
- Journal of Social Work in End-of-Life and Palliative Care, 6(3-4), July 2010, pp.164-184.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia
This study examined the role of adult children in end-of-life decision making among Korean American older adults and how culture influences this process. A total of 23 participants, aged at least 65 years, born in Korea or other East Asian country participated in three focus groups conducted in the Korean language at two senior centres in New York City. Participants were 61.9% female with a mean age of 71.2 years; 52.4% lived with their children. No participants had completed an advance directive and few had discussed end-of-life treatment preferences. Participants reported experiencing negative responses from their children when they attempted to discuss their end-of-life treatment preferences. Views about the role of children in this decision making were varied. Many participants wanted to make their own decisions about their end-of-life care. However some participants preferred family-based decision making, particularly by children, feeling that their children would make better decisions on their behalf. Most participants preferred their eldest son to be the sole decision maker, but there was also support for having all the children jointly make decisions about end-of-life care. Filial piety was discussed as an important cultural factor influencing the decision making process among parents and children. Study participants varied in their beliefs about whether their children would adhere to their wishes. Implications for social work practice are discussed. It is concluded that social workers have an import role in working with older Korean American patients and their children to elicit and achieve adherence to end-of-life treatment preferences.