Content of advance directives for individuals with advanced dementia

Patrick Triplett, Betty S. Black, Hilary Phillips, Sarah Richardson Fahrendorf, Jack Schwartz, Andrew F. Angelino, Danielle Anderson, Peter V. Rabins

Research output: Contribution to journalReview article

Abstract

Objectives: To examine how people with end-stage dementia have conveyed their wishes for end-of-life care in advance directives. Method: The documents of 123 residents of three Maryland nursing homes, all with end-stage dementia, were reviewed. Results: More years of education and White race were significantly associated with having an advance directive. With the exceptions of comfort care and pain treatment, advance directives were used primarily to restrict, not request, many forms of care at the end of life. Decisions about care for end-stage conditions such as Alzheimer's dementia are less often addressed in these documents than for terminal conditions and persistent vegetative state. Discussion: For advance directives to better reflect a person's wishes, discussions with individuals and families about advance directives should include a range of care issues in the settings of terminal illness, persistent vegetative state or end-stage illness. These documents should be reviewed periodically to make certain that they convey accurately the person's treatment preferences.

Original languageEnglish (US)
Pages (from-to)583-596
Number of pages14
JournalJournal of Aging and Health
Volume20
Issue number5
DOIs
StatePublished - Aug 1 2008

Keywords

  • End of life
  • End-stage dementia
  • Health care decisions
  • Living will
  • Treatment preferences

ASJC Scopus subject areas

  • Health(social science)
  • Sociology and Political Science
  • Life-span and Life-course Studies

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