This report provides nationally representative data on documentation of advance directives (ADs) among home health (HH) and hospice patients. Advance directives were recorded for 29% of HH patients and 90% of hospice discharges. Among HH patients, increasing age and use of assistive devices were associated with greater odds of having an AD, while being Hispanic or black (relative to white) and enrolled in Medicaid decreased the odds of having ADs. Among hospice discharges, being enrolled in Medicare and having 4 or 5 activities of daily living (ADL) limitations were associated with higher odds of ADs while depression, use of emergency services, and being black (relative to White) were associated with lower odds. Even after adjustment for potentially confounding factors, racial differences persist in AD documentation in both care settings.
LawR.‘Bridging worlds’: meeting the emotional needs of dying patients. J Adv Nurs. 2009;65(12):2630–2641. Epub October 2009.
4.
IecovichECarmelSBachnerYG.Where they want to die: correlates of elderly persons’ preferences for death site. Soc Work Public Health. 2009;24(6):527–542.
5.
SchraderSLNelsonMLEidsnessLM.“South Dakota’s Dying to Know”: a statewide survey about end of life. J Palliat Med. 2009;12(8):695–705.
6.
MittyEFloresS.There’s no place like home. Geriatr Nurs. 2009;30(2):126–129.
7.
KelloggFRCrainMCorwinJBricknerPW.Life-sustaining interventions in frail elderly persons. Talking about choices. Arch Intern Med. 1992;152(11):2317–2320.
8.
SchwarzJ.Exploring the option of voluntarily stopping eating and drinking within the context of a suffering patient’s request for a hastened death. J Palliat Med. 2007;10(6):1288–1297.
9.
TerryWOlsonLGWilssLBoulton-LewisG.Experience of dying: concerns of dying patients and of carers. Intern Med J. 2006;36(6):338–346.
ResnickHESchuurJDHeinemanJStoneRWeissmanJS.Advance directives in nursing home residents aged ≥65 years: United States 2004. Am J Hospice Pall Care Med. 2009;25(6):476–482.
20.
DobalianA.Advance care planning documents in nursing facilities: results from a nationally representative survey. Arch Gerontol Geriatr. 2006;43(2):193–212.
21.
LevyCRFishRKramerA.Do-not-resuscitate and do-not-hospitalize directives of persons admitted to skilled nursing facilities under the Medicare benefit. J Am Geriatr Soc. 2005;53(12):2060–2068.
22.
DegenholtzHBArnoldRAMeiselALaveJR.Persistence of racial disparities in advance care plan documents among nursing home residents. J Am Geriatr Soc. 2002;50(2):378–381.
23.
KurellaTMGoldsteinMKPeres-StableEJ.Preferences for dialysis withdrawal and engagement in advance care planning within a diverse sample of dialysis patients. Nephrol Dial Transplant. 2010;25(1):237–242.
24.
JohnsonRWNewbyLKGrangerCB. Differences in level of care at the end of life according to race. Am J Crit Care. 2010;19(4):335–343.
25.
YancuCNFarmerDFLeahmanD.Barriers to hospice use and palliative care services use by African American adults. Am J Hosp Palliat Care. 2010;27(4):248–253.
26.
JohnsonKSKuchibhatlaMTulskyJA.What explains racial differences in the use of advance directives and attitudes toward hospice care?J Am Geriatr Soc. 2008;56(10):1953–1958.
27.
AlanoGJPekmezarisRTaiJY. Factors influencing older adults to complete advance directives. Palliat Support Care. 2010;8(3):267–275.
