{"doi":"10.1177/10499091251338252","title":"Advance Care Planning Engagement of Older Adults in the Emergency Department","abstract":"BackgroundAdvance care planning (ACP) helps older adults make end-of-life medical decisions. While ACP discussions are associated with improved patient outcomes, overall engagement remains low in the emergency department (ED).ObjectivesThis study assessed ACP engagement in older ED patients.MethodsWe conducted a questionnaire study among adults ≥65 in a Boston ED (July-Oct 2023). Our primary outcome was ACP Engagement as measured by a validated 9-item instrument with three ACP self- efficacy and six ACP readiness questions. Secondary outcomes included participants' preferences for learning about five ACP topics in the ED-medical decision makers, what matters most, leeway and flexibility for decision makers, sharing wishes, and asking questions)-as well as their favored learning formats (eg, pamphlets, videos, clinician conversations). Each was rated on a 5-point Likert scale. We examined the relationship between ACP engagement and existing electronic health record (EHR) documentation.ResultsNinety-nine older adults participated (mean age 75.5; 53.5% women). On the 9-item ACP Engagement Survey, participants reported high overall scores with a mean of 4.1 (95% CI: 4.0-4.2). Among ACP readiness topics, 80 (81.6%) named a decision-maker; 37 (40.2%) discussed end-of-life wishes with doctors. Participants preferred ED team conversations. Among the 51 participants who reported having signed paperwork regarding end-of-life wishes, only 7 (13.7%) had forms documented in the EHR.ConclusionsAmong older adults in a large Boston-based ED, ACP engagement was high, but few patients had documentation of end-of-life wishes available in the EHR. Findings highlight the need for better ACP documentation in EDs.","journal":"American Journal of Hospice and Palliative Medicine®","year":2025,"id":564807,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.966,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1468040,"name":"Kenji Numata","orcid":"0000-0001-9813-5592","position":1,"is_corresponding":false},{"id":1468446,"name":"Justin Wolozin","orcid":null,"position":2,"is_corresponding":false},{"id":1468447,"name":"Zara Foroohar","orcid":null,"position":3,"is_corresponding":false},{"id":936716,"name":"Carlo Ottanelli","orcid":null,"position":4,"is_corresponding":false},{"id":329374,"name":"Ryan C. Burke","orcid":"0000-0001-5327-5735","position":5,"is_corresponding":false},{"id":496986,"name":"Erin K. Kross","orcid":"0000-0002-8206-3050","position":6,"is_corresponding":false},{"id":237755,"name":"Rebecca L. Sudore","orcid":"0000-0003-4436-2209","position":7,"is_corresponding":false},{"id":105982,"name":"Nathan I. Shapiro","orcid":"0000-0003-3508-4390","position":8,"is_corresponding":false},{"id":344265,"name":"Mara A. Schonberg","orcid":"0000-0001-5162-5922","position":9,"is_corresponding":false},{"id":1060323,"name":"Kei Ouchi","orcid":"0000-0002-2723-4259","position":10,"is_corresponding":false},{"id":234939,"name":"Adrian D. Haimovich","orcid":"0000-0002-4106-7055","position":0,"is_corresponding":true}],"reference_count":25,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:56:24.872312Z","pmid":"40271984","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}