Learning Objective #1: Use Erikson's Integrity vs Despair and Blumer's Symbolic Interactionism Theory to qualitatively study spirituality and advance directive decision making among well older adults

Learning Objective #2: State how findings from this study can increase understanding regarding how well older adults define and incorporate spirituality in advance directive decision making

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A review of the literature regarding spirituality and advance directive decision making among well older adults revealed that virtually no studies exist qualitatively exploring how well older adults define spirituality, if they perceive spirituality as being an important part of advance directive care planning, and the role that spirituality may play in the desired care that well older adults wish to receive at the end of life. The current lack of research reveals the necessity of exploring spirituality and advance directive decision making among well older adult populations. The purpose of this grounded theory study, based on Strauss and Corbin's (1998) grounded theory methodology, is to investigate the meaning, definition, and needs regarding spirituality and end of life care among well older adults aged 65 years and older in relation to advance directive decision making. The primary aims of this study are to: 1) describe the meaning and definition of spirituality in relation to advance directive decision making from the perspective of the well older adult, 2) to explain factors constituting spirituality and advance directive decision making among well older adults, and 3) to explain how well older adults use spirituality to discuss and engage in decision making related to advance directive care planning needs. Erikson's developmental stage, Integrity versus Despair, and Blumer's (1969) Symbolic Interaction theory will form the theoretical orientation for this study. Purposive sampling will be used to recruit well elderly subjects from local community senior citizen centers and by word of mouth until data saturation occurs as per Strauss and Corbin's (1998) grounded theory methodology. Individual semi-structured interviews and focus groups will be used to collect data. Based on the analysis of data, a theoretical model will be constructed reflecting the basic social process of how well older adults use spirituality in advance directive decision making.