End-of-Life Conversations as a Legacy.

Area of Science:

• Healthcare Decision-Making
• Palliative Care
• Nursing Practice

Background:

• Advance directives, including living wills and health care powers of attorney, are crucial for patients to avoid unwanted medical care when incapacitated.
• Despite increased focus on advance care planning, a significant gap exists, with approximately two-thirds of American adults lacking advance medical directives.
• While 90% of individuals deem discussing end-of-life wishes important, only 27% have actually engaged in these conversations.

Purpose of the Study:

• To highlight the importance of advance directives in patient-centered end-of-life care.
• To underscore the gap between the perceived importance and actual utilization of advance care planning.
• To emphasize the role of nurses in facilitating patient decision-making and end-of-life conversations.

Main Methods:

• This study synthesizes existing knowledge on advance care planning and patient decision-making.
• It reviews literature concerning the factors influencing the completion of advance medical directives.
• The focus is on the psychosocial aspects influencing end-of-life care discussions.

Main Results:

• A substantial majority of American adults do not possess advance medical directives.
• There is a significant disparity between the perceived importance of discussing end-of-life wishes and the actual occurrence of such discussions.
• Complex psychosocial factors influence individuals' healthcare decisions and their engagement in advance care planning.

Conclusions:

• Nurses must understand the multifaceted factors influencing healthcare decisions to effectively support patients.
• Encouraging open conversations among patients, families, friends, and healthcare providers is essential for clarifying end-of-life care preferences.
• Promoting advance care planning is vital for respecting patient autonomy and ensuring care aligns with their values.