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Article

Factors Associated with Family Caregivers’ Intentions to Complete an Advance Directive for Individuals with Dementia: A Cross-Sectional Descriptive Study

1
Intensive Care Unit, Yuseong Sun Hospital, Daejeon 34084, Republic of Korea
2
Department of Nursing, The Catholic University of Korea, Seoul 06591, Republic of Korea
3
Department of Nursing, Kongju National University, Gongju-si 32588, Republic of Korea
*
Author to whom correspondence should be addressed.
Healthcare 2025, 13(11), 1297; https://doi.org/10.3390/healthcare13111297
Submission received: 8 April 2025 / Revised: 25 May 2025 / Accepted: 28 May 2025 / Published: 29 May 2025

Abstract

Background/Objectives:As dementia progresses, patients often lose decision-making capacity, leaving family members responsible for making critical end-of-life (EOL) care decisions. This cross-sectional descriptive study explored the factors associated with the intention to complete an advance directive (AD) among family caregivers of older adults with dementia in South Korea. Methods: This study surveyed 140 caregivers aged 20 years or older to assess their knowledge of advance directives (ADs), preferences for EOL care, and attitudes toward withdrawing life-sustaining treatment (LST). Data were collected from 1 August to 14 August 2024, and analyzed using descriptive statistics, the Chi-squared test, Fisher’s exact test, Spearman’s correlation, and logistic regression, with SPSS/WIN 28.0. Results: The intention to complete an AD significantly differed by religion (p = 0.004) and the functional status of the patient with dementia (p = 0.012). There was a positive correlation between intention to complete an AD and knowledge of ADs (r = 0.23, p = 0.007). Factors associated with intention to complete an AD included religion (OR = 4.36, p = 0.028) and knowledge of ADs (OR = 1.16, p = 0.033), explaining 22.2% of the variance, which is considered meaningful in studies dealing with complex psychosocial and behavioral variables. Conclusions: These findings suggest that religious affiliation and knowledge of ADs may contribute to greater emphasis on EOL preparedness and self-determination. To promote informed decision making, it is essential to implement targeted educational interventions—such as community-based workshops, telehealth counseling, and in-clinic guidance—that enhance caregivers’ understanding of ADs and empower them in their caregiving roles.
Keywords: advance directives; caregivers; dementia; terminal care advance directives; caregivers; dementia; terminal care

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MDPI and ACS Style

Park, H.; Kang, S.; Kim, Y. Factors Associated with Family Caregivers’ Intentions to Complete an Advance Directive for Individuals with Dementia: A Cross-Sectional Descriptive Study. Healthcare 2025, 13, 1297. https://doi.org/10.3390/healthcare13111297

AMA Style

Park H, Kang S, Kim Y. Factors Associated with Family Caregivers’ Intentions to Complete an Advance Directive for Individuals with Dementia: A Cross-Sectional Descriptive Study. Healthcare. 2025; 13(11):1297. https://doi.org/10.3390/healthcare13111297

Chicago/Turabian Style

Park, Hyeseon, Sujin Kang, and Youngji Kim. 2025. "Factors Associated with Family Caregivers’ Intentions to Complete an Advance Directive for Individuals with Dementia: A Cross-Sectional Descriptive Study" Healthcare 13, no. 11: 1297. https://doi.org/10.3390/healthcare13111297

APA Style

Park, H., Kang, S., & Kim, Y. (2025). Factors Associated with Family Caregivers’ Intentions to Complete an Advance Directive for Individuals with Dementia: A Cross-Sectional Descriptive Study. Healthcare, 13(11), 1297. https://doi.org/10.3390/healthcare13111297

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