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Why are elderly people not using advance directives?

D M High1

  • 1Department of Philosophy, University of Kentucky, Lexington 40506.

Journal of Aging and Health
|October 5, 1993
PubMed
Summary
This summary is machine-generated.

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Advance directives for healthcare are underutilized by seniors. A study found most elderly individuals prefer family surrogates, suggesting a need to restructure the process to include family authorization for healthcare decisions.

Area of Science:

  • Gerontology
  • Health Law
  • Bioethics

Background:

  • Advance directives are crucial for patient autonomy in healthcare.
  • Low usage rates among the elderly highlight a gap in current strategies.
  • Understanding barriers is key to improving healthcare planning for seniors.

Purpose of the Study:

  • To evaluate the effectiveness of various educational strategies in increasing advance directive completion among older adults.
  • To identify primary barriers preventing elderly individuals from completing advance directives.
  • To propose policy changes accommodating the preferences of elderly individuals regarding healthcare decision-making.

Main Methods:

  • A study involving 293 elderly participants (ages 65-93) tested six different educational interventions.
Keywords:
Death and EuthanasiaEmpirical ApproachProfessional Patient Relationship

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  • Follow-up interviews were conducted with intervention participants and a control group.
  • Statistical analysis was used to compare the usage rates of advance directives across groups.

    • Main Results:

    • Only one of the six tested educational strategies significantly increased the use of advance directives.
    • Lack of information and procrastination were not the main barriers identified.
    • A majority of participants expressed a preference for deferring healthcare decisions to family surrogates.

    Conclusions:

    • Current educational strategies are largely ineffective in increasing advance directive adoption among the elderly.
    • The preference for family involvement in healthcare decision-making is a significant factor.
    • Restructuring the advance directive process to formally include family authorization could improve compliance and respect patient wishes.