Question 5

In one study, up to 90% of advance directives documented that patients did NOT want to receive all medical care possible, but preferred either limited care or comfort-focused care.  Those with advanced directives were are less likely to receive aggressive care at the end of life, which is what most prefer. 

Documentation of end-of-life conversations between physicians and patients earlier (versus later or not at all) is associated with improved outcomes for bereaved caregivers.  (Wright, A.A., et al., Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment. JAMA, 2008. 300 (14): p. 1665-73.)

Comparing patients who have had an advance care planning conversation to those who haven't failed too show any increase in patient distress or mental health. (Wright, A.A., et al., Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment. JAMA, 2008. 300 (14): p. 1665-73.)

Completion of advance directive is associated with an increased likelihood of patients medical care aligned with their preferences.  In one study, up to 90% of advance directives documented that patients did NOT want to receive all medical care possible, but preferred either limited care or comfort-focused care. (Silveira, MJ. NEJM 362:13:2010.)