Advance directives (ADs) are legal documents. These can be used to state in advance what medical treatments you wish to take or not under certain circumstances.
End-Stage Renal Disease Patients Lack Advance Directives Near the End of Life
Many nursing home residents receiving dialysis do not have advance directives that sufficiently address end-of-life treatment decisions.
Many nursing home residents receiving dialysis do not have advance directives that sufficiently address end-of-life treatment decisions.
‘Advance directives (ADs) engages older couples in planning for their end-of-life.’
You also can use an AD to name one or more people to act on your behalf if you are ever unable or uncomfortable making your own healthcare decisions. They are also more likely to die at home instead of in a hospital, and they receive hospice care earlier and for longer periods of time. About 50 percent of people 65 and older in the United States have completed ADs. However, little is known about why some people have them while others do not.
Most research treats the decision to complete an AD as an individual choice, but we know little about the roles that spouses and other family members may play in a person's decision to engage in end-of-life planning.
Medicare End-of-Life Spending Reduced by Advance Directives Related to Use of Palliative Care
A University of Michigan study says that advance directives do have an impact on health care at the end of life
A University of Michigan study says that advance directives do have an impact on health care at the end of life
The study's researcher, Catheryn S. Koss, JD, PhD, of the Gerontology Center, University of Kansas, examined information from 2,243 married couples aged 65 and older who had participated in the Health and Retirement Study during 2004-2012.
Advertisement
Changing Procedures at Nursing Homes Could Improve End-of-Life Patient Care
Advance directives improve the dying experience for nursing home residents and decrease the cost of end-of-life care while honoring residents' expressed wishes.
Advance directives improve the dying experience for nursing home residents and decrease the cost of end-of-life care while honoring residents' expressed wishes.
- Age
- Education
- Poor health
- Prior hospitalizations and/or outpatient surgeries (those that don't require an overnight hospital stay)
- Having greater household assets Among participants in the study, 57 percent of men and 56 percent of women had ADs. Both spouses had ADs in 46 percent of couples and neither had ADs in 33 percent of couples. Some of the insights the study revealed include:
- Age (for an individual and his/her spouse) was linked to having an AD for both men and women.
- Men's education was associated with having their own AD and an AD for their wives.
- The worse a wife's health, the less likely a man was to have an AD.
- Hospitalization and/or outpatient surgery for men was associated with having an AD for both spouses.
- Women with regular healthcare providers were more likely to have an AD, but this did not hold true for men. The results of this study suggest that having an AD among older married adults is affected both by the characteristics of individuals in a married relationship, as well as their joint experience as a couple. Furthermore, how spouses influence one another's advance care planning seems to differ by gender.
Advertisement
Doctors And Relatives Often See Patients' Wishes Differently: Study
Doctors often judge advance directives to be unclearly worded and not applicable to the patient's current situation.
Doctors often judge advance directives to be unclearly worded and not applicable to the patient's current situation.
