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

## TL;DR

This study explores what influences family caregivers in South Korea to plan for end-of-life care for dementia patients through advance directives.

## Contribution

The study identifies religion and knowledge about advance directives as key factors influencing caregivers' intentions to complete these documents.

## Key findings

- Religion and patient functional status significantly influence caregivers' intention to complete advance directives.
- Higher knowledge of advance directives correlates with a stronger intention to complete them.
- Educational interventions are recommended to improve caregivers' understanding and decision-making.

## 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.