Elderly patients' understanding of advance directives

Growing evidence suggests that advance directives (ADs) are often ineffective. Further explanation of how these documents are viewed by the public, the expectations of how decisions about treatment are made, and, in particular, patients' understanding of how ADs are actually used in the clinical setting, are warranted. This article details a descriptive study in which patients were interviewed, during hospital stays, about their beliefs and understanding of advanced directives, as well as the processes used in completing them. The study was undertaken in a community hospital located in a rural area in the Midwest. Findings show that many patients were able to clearly articulate what an AD means in terms of making their choices known. However, misconceptions were found in patients' understanding of ADs and only 46% reported discussing their ADs with a physician. Strategies for effective implementation of education programs related to ADs are detailed here.