Hospice Care and Advance Directives

Advance directives are important legal documents that can be completed long before a patient is ill. The healthcare power of attorney, also known as the durable power of attorney for healthcare, designates the healthcare proxy, who is the person assigned to make medical decisions for the patient when the patient is no longer able to do so. The living will states the patient’s wishes regarding the administration of end-of-life medical treatment when the patient cannot state them.

Advance directives are available at hospitals, physicians’ offices, legal offices, state health departments, and on the Internet. All states do not have the same forms. People can register completed forms at the U.S. Living Will Registry, which makes their requests available to hospitals and healthcare providers across the country 24 hours a day.

In a national research study on advance directives, the Journal of the American Geriatrics Society reported that of the 1,587 who died in nursing homes, hospitals, and at home, 70.8% had Advance Directives. Hospice patients were more likely to have them. Patients with Advance Directives were less likely to use a feeding tube or respirator during the last month of life. Among other conclusions, the study determined that Advance Directives were associated with greater use of hospice and fewer concerns with physician communication and information about what to expect.

The Five Wishes document is unique among all other living will and health agent forms because it looks to all of a person's needs: medical, personal, emotional and spiritual. This document helps people express how they want to be treated if they are seriously ill and unable to speak for themselves. Click here for more information on the Five Wishes document.

Frances Shani Parker, Author
"Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”
Hospice and Nursing Homes Blog