Older people's responses to education about advance directives

As advances in medical technology increase the life span, social workers committed to quality of life for elderly people are faced with practice challenges. Preserving the autonomy and civil rights of elderly people in guiding their own health care even if they are unable to articulate preferences has become an important area of social work intervention. This article evaluates a social work program in a rural New England community designed to promote autonomous decision making by educating elderly people about advance directives. Results revealed a continuum of willingness among elderly people to address future decision making. Interventions to promote autonomy in health care decision making need to address the diversity of elderly people. The primacy of the family emerged throughout the study, suggesting that advance directives may be a family issue rather than solely an individual one. Further needs assessment research is needed to guide program development in this essential area of social work practice.