Advance Directive Preferences Among Subpopulations of Asian Nursing Home Residents in the Pacific Northwest

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Abstract
OBJECTIVE: To study advance directives (code status) among subgroups of Asian nursing home residents. DESIGN: Cross‐sectional design. PARTICIPANTS AND SETTING: A total of 423 residents of Asian descent (aged >55) from two ethnic nursing homes in Seattle, Washington. METHODS: Chart review was conducted on 423 residents (199 discharged between 1995 and 1998 and 244 current residents) to ascertain code status, age, gender, ethnicity, comorbidity (using the Charlson Index), and religion. RESULTS: Seventy percent of the residents were women, median age was 83 ± 9, 43% were Chinese, 40% Japanese, and 17% other Asian (Korean, Filipino, Southeast Asian). The majority of the patients in any subgroup (72% overall) were ‘no code’. In bivariate analysis, ethnicity, increased age, and comorbidity were correlated with no code status. In multivariable logistic regression, Japanese residents were more likely to be no code (OR 4.1 (95% CI, 3.1‐ 5.4)) controlling for age, comorbidity, gender, and religion. Chinese were more likely to be full code (OR 3.3 (95% CI, 2.6–4.2)). CONCLUSIONS: Code status differs significantly among Asian subgroups in these ethnic nursing homes. Whereas the majority of residents are no code, Japanese residents are more likely than Chinese or others to be no code. Higher age and comorbidity are also correlated with no code status. J Am Geriatr Soc 48: 554–557, 2000.

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