Advance Directives

Contents:

Research conducted by: RAND Health; RAND Labor and Population

All Items (18)

JOURNAL ARTICLE

Inter-vivos Giving By Older People in the United States: Who Received Financial Gifts from the Childless? — Dec 31, 2008

Using data for 1996 to 2004 from the United States Health and Retirement Study, this article examines the differences between parents and childless older people in financial transfers to people other than their children.

JOURNAL ARTICLE

The Impact of Late-Life Parental Death on Adult Sibling Relationships: Do Parents' Advance Directives Help or Hurt? — Dec 31, 2008

The authors examined whether the effect of parental death on adults siblings' relationship quality varies on the basis of the presence and perceived effectiveness of a deceased parent's formal preparations for end-of-life care.

JOURNAL ARTICLE

Use of Advance Directives for Nursing Home Residents in the Emergency Department — Dec 31, 2007

Finds variability in advance directive documentation for nursing home patients on transfer to the emergency department, and finds that emergency clinicians experience substantial difficulty in reliably obtaining information about advance directives.

JOURNAL ARTICLE

Advance Care Planning Among the Oldest Old — Dec 31, 2007

Even in a system known for high-quality chronic illness care, documentation of advance care planning and proxies for health decisions at end of life was infrequent. Involvement of outpatient primary care and geriatric providers may improve care.

JOURNAL ARTICLE

Evidence for Improving Palliative Care at the End of Life: A Systematic Review — Dec 31, 2007

Assesses evidence about interventions to improve palliative and end-of-life care.

JOURNAL ARTICLE

Quality Indicators for Palliative and End-of-Life Care in Vulnerable Elders — Dec 31, 2006

The literature summaries that support each indicator judged valid by the expert panel are described.

JOURNAL ARTICLE

Advance Care Planning for Fatal Chronic Illness: Avoiding Commonplace Errors and Unwarranted Suffering — Dec 31, 2002

The authors discuss serious, recurring, and generally unnoticed errors in planning for care near the end of life and possible steps toward improvement. Repairing these shortcomings will require quality improvement and system redesign efforts, methods familiar from patient safety initiatives. Reliable improvement will also require making it unacceptable for clinicians to fail to plan ahead for care during fatal chronic illness.

JOURNAL ARTICLE

Disaster Planning: Making Decisions in Advance for Very Sick Patients — Dec 31, 2002

Advanced care planning to avoid unwanted care at the end of life remains a low priority in patient care.

JOURNAL ARTICLE

End-of-life Discussions and Preferences Among Persons with HIV — Dec 31, 2000

Half of all persons infected with HIV are at risk of making end-of-life decisions without prior discussions with their health care practitioners. Blacks, Latinos, intravenous drug users, and less educated individuals need advance care planning interventions in clinical HIV programs.

JOURNAL ARTICLE

Insights About Dying from the SUPPORT Project — Dec 31, 1999

Although SUPPORT aimed to describe and compare decision-making affecting seriously ill patients, it also illuminated many other aspects of their course near death.

JOURNAL ARTICLE

Physician Understanding of Patient Resuscitation Preferences: Insights and Clinical Implications — Dec 31, 1999

Physicians often misunderstand seriously ill, hospitalized patients' resuscitation preferences, especially preferences to forego CPR. Factors associated with misunderstanding suggest that physicians infer patients' preferences without asking the patient. Patients who prefer to forego CPR but whose wishes are not understood by their physician may receive unwanted treatment

JOURNAL ARTICLE

Communication and Decision-Making in Seriously Ill Patients: Findings of the SUPPORT Project — Dec 31, 1999

SUPPORT documents that physicians and surrogates are often unaware of seriously ill patients' preferences.

JOURNAL ARTICLE

Age-related Differences in Care Preferences, Treatment Decisions, and Clinical Outcomes of Seriously Ill Hospitalized Adults: Lessons from SUPPORT — Dec 31, 1999

Even after adjustment for patients' prognoses and care preferences, seriously ill hospitalized older patients were treated less aggressively than younger patients.

JOURNAL ARTICLE

Decision-making and Outcomes of Prolonged ICU Stays in Seriously Ill Patients — Dec 31, 1999

Prolonged ICU stays were expensive and were often followed by death or disability.

JOURNAL ARTICLE

Patients Who Want Their Family and Physician to Make Resuscitation Decisions for Them: Observations from SUPPORT and HELP — Dec 31, 1999

These results underscore the need to understand resuscitation preferences within a broader context of patient values.

JOURNAL ARTICLE

Patient Age and Decisions to Withhold Life-Sustaining Treatments from Seriously Ill, Hospitalized Adults — Dec 31, 1998

Even after adjustment for differences in patients' prognoses and preferences, older age was associated with higher rates of decisions to withhold ventilator support, surgery, and dialysis.

JOURNAL ARTICLE

Outcomes, Preferences for Resuscitation, and Physician-Patient Communication Among Patients with Metastatic Colorectal Cancer — Dec 31, 1997

Describe characteristics, outcomes, and decision making in patients with colorectal cancer metastatic to the liver, and to examine the relationship of doctor-patient communication with patient understanding of prognosis and physician understanding of patients' treatment preferences.

JOURNAL ARTICLE

Epidemiology of Do-Not-Resuscitate Orders: Disparity By Age, Diagnosis, Gender, Race, and Functional Impairment — Dec 31, 1994

Examines the sample of patients with DNR orders in the DRG Quality of Care Study to determine the relationship between DNR orders and patient and hospital characteristics. The study found that after adjustment for sickness at admission and functional impairment, DNR orders were assigned more often to older patients and also differed by diagnosis (highest among CVA patients, lowest among acute myocardial infarction patients).

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