Implementing a pilot program of advanced directives in nursing homes

This project focused on employing a comprehensive advance directive, called Five Wishes, that is suited to a process-oriented approach emphasizing a discussion of personal, social, and emotional needs in end-of-life care. With findings of a limited number of advance directives completed, the traditional explanation of the 'onset o f progressive deterioration' a mong the residents is offered. Residents wi th low sense of self-efficacy is suggested as another explanation and one worthy of further research.