Advance Directives in Hospice Healthcare Providers: A Clinical Challenge

Area of Science:

• Palliative Care
• Healthcare Policy
• Medical Ethics

Background:

• Hospice healthcare providers witness the importance of advance directives for terminally ill patients.
• Lack of documented end-of-life care wishes can lead to adverse outcomes.
• Limited data exists on advance directive prevalence among hospice healthcare professionals.

Purpose of the Study:

• To explore the prevalence of advance directives among hospice healthcare providers.
• To identify factors influencing the completion rates of advance directives.
• To understand barriers to advance directive completion in this population.

Main Methods:

• A survey was e-mailed to 2097 healthcare providers and volunteers at a nonprofit hospice.
• The survey included 32 items assessing completion rates, barriers, knowledge, and demographics.
• 890 responses were analyzed to determine prevalence and influencing factors.

Main Results:

• 44% of respondents had completed an advance directive.
• Ethnicity, age, relationship status, and perceived knowledge significantly influenced completion.
• Barriers included procrastination, fear, and cost; 43% intended to complete one post-survey.

Conclusions:

• The majority of hospice healthcare providers lack completed advance directives, similar to oncologists.
• Surveys may serve as a catalyst for increasing advance directive completion rates.
• Increased discussion of end-of-life wishes with patients and families is encouraged.