Friday, April 4, 2014
A record number of elderly people are completing living wills to guide end-of-life medical treatments – up from 47 percent in 2000 to 72 percent in 2010 – according to new research from the University of Michigan and the Veterans Affairs Ann Arbor Healthcare System. However, even with nearly double the number of people completing advance directives – which may specify preferences for surrogate decision makers and life-support treatment – there was little difference in hospitalization rates or deaths in the hospital, says the study that appears in the Journal of the American Geriatrics Society.
"Given the aging population, there's been a great push to encourage more people to complete advance directives with the idea that this may increase hospice care and reduce hospitalization for patients during the last six months of life," says lead author and palliative care specialist Maria Silveira, M.D., M.A., M.P.H, researcher with the VA Ann Arbor Healthcare System and assistant professor in the Department of Internal Medicine at the U-M Medical School.
"We found that while there's an upward trend in creating these documents, it didn't have much bearing at all on hospitalization rates over the decade. Indeed, hospitalization rates increased during the decade, rather than go down. These are really devices that ensure people's preferences get respected, not devices that can control whether a person chooses to be hospitalized before death."
Silveira says the increase in advanced directives indicates that people are less timid about broaching end-of-life planning and talking about death with loved ones.