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Only About One in Three Americans Has Documented Their End-of-Life Wishes

July 11, 2017

A new study from the Perelman School of Medicine at the University of Pennsylvania about end-of-life care preferences and related documentation indicates that about 63 percent of Americans do not have their end-of-life care wishes in writing.

The primary document in which patients communicate their end-of-life care wishes is an advance directive, also called a living will. An advance directive is legally binding and does not expire, but can be changed by the patient at any time. It describes the care a patient wants to receive if they no longer are able to make their own medical decisions.

Other findings from the study include:

  • 29.3 percent had completed a living will with specific end-of-life care wishes documented
  • 33.4 percent had designated a health care power of attorney to make their decisions in the event they no longer were able
  • 38.2 percent of patients with a chronic illness completed an advance directive, compared to 32.7 percent of healthy adults
  • 45.6 percent of patients aged 65 and older completed an advance directive, compared to 31.6 percent of younger adults

The study’s researchers indicated that, during the data collection period of 2011 to 2016, the low rate of completion remained stagnant and did not appear to be increasing.

The researchers’ recommendations to address the low completion rates include identifying and addressing barriers, such as:

  • Redesigning the forms to better represent patient values and goals and better align with care preferences
  • Simplifying legal barriers to  execute  advance directives
  • Focusing on populations at high risk for poor end-of-life outcomes

End-of-life care planning is an important part of health care delivery. HAP and Pennsylvania’s hospitals remain strong advocates for end-of-life planning and continue to work toward helping patients to better understand their options, and identify and document their preferences for their own care.

HAP has information and resources available for members at its End-of-Life Care Planning web page. Consumers can learn more about advance directives in the consumer area of HAP’s web page.

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