End-of-life planning in a rural elderly cohort.

Relationships between end-of-life (EOL) planning and demographic and health related variables for individuals living in three rural West Texas counties were examined using a prospective cohort study design. Project FRONTIER, a longitudinal community-based participatory research project, served as the database for this study. Abstracted data from 692 older adults focused on demographic variables, medical conditions, and EOL planning. EOL planning activities included completing a will (39%), a durable power of attorney (32%), advanced directives (14%), talking with family about EOL wishes (31%), and designating a decision maker (55%). The mean EOL Planning Index was 1.6 (SD = 2.58) with higher numbers indicating greater level of planning. Regression findings supported significantly higher levels of EOL planning influenced by age, education, non-Hispanic ethnicity, chronic disease, depression, and communication with family about nursing home placement. Aging rural adults and their healthcare providers would benefit from learning more about EOL planning.