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More than one-quarter of elderly patients lack decision-making capacity at death
Date:3/31/2010

Ann Arbor, Mich. More than one in four elderly Americans lacked the capacity to make their own medical care decisions at the end of life, according to a study of 3,746 people to be published April 1 in the New England Journal of Medicine.

Those who had advance directives - including living wills or durable powers of attorney for healthcare - received the care they wanted most of the time, says lead author Maria Silveira, M.D., M.P.H., physician scientist at the VA Ann Arbor Healthcare System's Clinical Management Research and assistant professor of Internal Medicine at the University of Michigan.

"Prior to our study, no one knew how many elderly adults might need others to make complex medical decisions on their behalf at the end of life," says Silveira. "Our research shows that a substantial number of older adults need someone else to make decisions about whether aggressive, limited, or comfort care should be provided at the end of life."

"This study underscores the need to prepare oneself and one's family for the often emotional and difficult medical decisions that can arise at the end of life. It also suggests that the time spent to craft a living will and appoint a durable power of attorney for health care can be worthwhile."

Advance directives usually document patients' wishes for life-sustaining treatment in a living will, as well as their choice of a proxy decision-maker in a durable power of attorney for health care Advance directives are sanctioned in all 50 states and can be completed for free without the aid of an attorney. (Silveira recommends this site.)

Still, "There is a lot of myth and misunderstanding about advance directives," Silveira says.

For example, many people do not understand that advance directives are used only when patients can't make medical care decisions for themselves, and they can be revoked by the patient at any time, either in writing or orally. Advance directives
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Contact: Mary Masson
mfmasson@umich.edu
734-764-2220
University of Michigan Health System
Source:Eurekalert

Page: 1 2 3

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