Nearly Three-Quarters of U.S. Seniors Have Living Wills

Increase in advance directives has not affected hospitalization rates, study finds

WEDNESDAY, April 2, 2014 (HealthDay News) -- A record number of elderly Americans have living wills that explain their wishes for end-of-life medical care or appoint a surrogate medical decision maker, a new study finds.

The percentage of seniors with living wills -- also called advance directives -- increased from 47 percent in 2000 to 72 percent in 2010. However, there was little change in hospitalization rates or in-hospital deaths, according to the study.

"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," said study lead author Dr. Maria Silveira. She is an assistant professor in the department of internal medicine at the University of Michigan Medical School, and a researcher with the Veterans Affairs Ann Arbor Healthcare System.

"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," she said in a university news release. "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."

For the study, published April 2 in the Journal of the American Geriatrics Society, the researchers analyzed data from the Health and Retirement Study, which is conducted by the University of Michigan Institute for Social Research on behalf of the U.S. National Institute on Aging.

The rising number of seniors with living wills suggests that Americans are more willing to discuss death and end-of-life planning with loved ones, said Silveira.

"People seem more comfortable having 'the talk' about those dire 'what-if' scenarios and death in general," she said. "It's become part of the routine check list in getting affairs in order, especially for older adults."

Many of these people want to ease the burden upon their loved ones when it comes to handling finances, medical treatment and other matters, Silveira added.

Most elderly people with advance directives appointed a medical decision-making surrogate and outlined their end-of-life treatment preferences. Among those who took only one of those measures, most appointed a surrogate, the study found.

"Identifying the person you trust to make these types of medical decisions isn't as emotional a decision as deciding whether you'd want aggressive treatment or hospice care if you're dying," Silveira said.

"It's much more difficult to make decisions about treatment because it often depends on unforeseeable factors such as how sick the person is, whether his or her brain is working and chances of recovery," she explained.

More information

The U.S. National Library of Medicine has more about advance directives.

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