Advance directives for elderly people: worthwhile cause or wasted effort?

This article examines whether elderly individuals who had executed an advance directive for health care were more likely to have their wishes understood by their designated surrogates than elderly individuals who had not executed an advance directive. A sample of 153 elderly people was drawn from two nursing homes and two senior citizen housing complexes; 40 of the participants had executed an advance directive. Concordance was measured using six hypothetical health care scenarios and was evaluated by assessing the percentage of agreement and directionality of discordant responses. The mere completion of an advance directive did not guarantee a surrogate decision maker's awareness of the older person's wishes. Education, communication, and supportive intervention are also needed. As educators, facilitators, and enablers, social workers are well suited for this role.