Centre for Policy on Ageing



Which advance directive matters? — an analysis of end-of-life decisions made in nursing homes
Author(s)	Jiska Cohen-Mansfield, Steven Lipson
Journal title	Research on Aging, vol 30, no 1, January 2008
Pages	pp 74-92
Keywords	Terminal care ; Medical care ; Rights [elderly] ; Wills ; Nursing homes ; United States of America.
Annotation	This study clarifies the role of advance directives in the process of decision-making in nursing homes in respect of the US Patient Self-Determination Act (Omnibus Budget Reconciliation) Act 1990. Physicians reported on the actual use of advance directives in a medical decision-making process related to status changes in 70 nursing home residents (mean age 89). Charts were also reviewed to assess the specifics of the advance directives. Despite high prevalence of advance directives, the directives themselves had a very limited role in affecting treatments. The physicians surveyed viewed directives relating to admission to hospital as the most useful, though these were not the most available directives. The format of, and attention given to, advance directives in the nursing home may need to be re-evaluated. (RH).
Accession Number	CPA-080121213 A
Classmark	LV: LK: IKR: VTH: LHB: 7T
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...from the Ageinfo database published by Centre for Policy on Ageing.