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Journal of Aging Research
Volume 2013, Article ID 470812, 8 pages
Research Article

Older Adults Making End of Life Decisions: An Application of Roy's Adaptation Model

Nell Hodgson Woodruff School of Nursing Emory University, 1520 Clifton Road, Atlanta, GA 30322-4207, USA

Received 2 May 2013; Accepted 15 October 2013

Academic Editor: Barbara Shukitt-Hale

Copyright © 2013 Weihua Zhang. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. The purpose of this study was to identify variables that influenced completion of advanced directives in the context of adaptation from national data in older adults. Knowledge gained from this study would help us identify factors that might influence end of life discussions and shed light on strategies on effective communication on advance care planning. Design and Method. A model-testing design and path analysis were used to examine secondary data from 938 participants. Items were extracted from the data set to correspond to variables for this study. Scales were constructed and reliabilities were tested. Results. The final path model showed that physical impairment, self-rated health, continuing to work, and family structure had direct and indirect effects on completion of advanced directives. Five percent of the variance was accounted for by the path analysis. Conclusion. The variance accounted for by the model was small. This could have been due to the use of secondary data and limitations imposed for measurement. However, health care providers and families should explore patient’s perception of self-health as well as their family and work situation in order to strategize a motivational discussion on advance directive or end of life care planning.