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Research on Aging
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Which Advance Directive Matters? An Analysis of End-of-Life Decisions Made in Nursing Homes

Jiska Cohen-Mansfield

Research Institute on Aging of the Hebrew Home of Greater Washington

Steven Lipson

Research Institute on Aging of the Hebrew Home of Greater Washington

This study clarifies the role of advance directives in the process of decision making in nursing homes. Physicians reported on the actual use of advance directives in a medical decision-making process related to status changes in 70 nursing home residents (mean age = 89 years). Charts were also reviewed to assess the specifics of the advance directives. Despite a high prevalence of advance directives, the directives themselves had a very limited role in affecting treatments. The physicians surveyed viewed directives related to hospitalization as the most useful, though these were not the most available directives. The attention and format given to advance directives in the nursing home may need to be reevaluated.

Key Words: advance care planning • advance directives • nursing homes • dementia

Research on Aging, Vol. 30, No. 1, 74-92 (2008)
DOI: 10.1177/0164027507307925
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?