Affiliation:
1. Johns Hopkins University School of Medicine,
2. Johns Hopkins University School of Medicine
3. Columbia, Maryland
4. AEGON Direct Marketing Services
5. Maryland Attorney General's Office
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.
Subject
Geriatrics and Gerontology,Community and Home Care,Gerontology
Cited by
59 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献