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A method for increasing elders' use of advance directives

M K Luptak1, C Boult

  • 1Department of Family Practice and Community Health, University of Minnesota, Minneapolis 55414.

The Gerontologist
|June 1, 1994
PubMed
Summary

An interdisciplinary intervention effectively helped frail elderly individuals document advance directives (AD). Most participants recorded AD, named a proxy, and specified treatment preferences, improving end-of-life care planning.

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Area of Science:

  • Geriatrics
  • Public Health
  • Bioethics

Background:

  • Few elderly individuals have documented advance directives (AD), impacting end-of-life care planning.
  • Frail elders often face challenges in articulating and recording their healthcare wishes.
  • Advance directives are crucial for respecting patient autonomy and guiding medical decisions.

Purpose of the Study:

  • To evaluate the effectiveness of an interdisciplinary intervention in facilitating the recording of advance directives among ambulatory frail elders.
  • To assess the rates of AD documentation, proxy designation, and specific treatment preference recording within the study population.

Main Methods:

  • An interdisciplinary team, including physicians, a social worker, and a trained lay volunteer, provided information and counseling.
Keywords:
Death and Euthanasia

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  • Intervention involved multiple visits to a geriatric evaluation and management (GEM) clinic for elderly subjects, their families, and designated proxies.
  • The intervention focused on education and support to encourage AD completion.

    • Main Results:

    • Seventy-one percent of the elderly subjects successfully recorded advance directives.
    • Of those who recorded AD, 96% designated a healthcare proxy.
    • A significant majority (83%) of participants specified their treatment preferences within their AD.

    Conclusions:

    • The interdisciplinary intervention model is effective in increasing advance directive completion rates among frail elders.
    • The intervention successfully facilitated proxy appointments and the articulation of specific treatment preferences.
    • This approach can improve end-of-life care planning and ensure patient autonomy for vulnerable elderly populations.