Study Reveals Need for Nursing Homes to Improve Advance Directives

Law Firm Newswire



San Francisco, CA (Law Firm Newswire) April 26, 2017 – Nursing homes should implement better procedures for end-of-life directives, according to the results of a new study published in Health and Social Work. Past research has indicated that not only do advance directives help improve end-of-life care for nursing home residents but they also cut health care costs.

“Advance directives honor an individual’s expressed wishes about health care. Every adult age 18 and over should sign an advance health care directive,” said estate planning attorney Mark Gilfix. “It is very important for families to discuss end-of-life wishes and health care concerns before an emergency arises. That way, no relative or nursing home staff is left guessing what type of care a person wants if they are no longer able to communicate their wishes.”

Findings from the University of Missouri School of Social Work suggest nursing homes should devote more attention to the use of advance directives. A research team examined 1,800 medical files from nursing homes in St. Louis, Missouri. They found only around 50 percent of the files included an advance directive. In many of these cases, the advance directives were hard to locate due to inadequate record keeping.

On a national level, between 65 percent and 70 percent of nursing home residents have such directives on file, said university researchers. The study concluded that by failing to include advance directives in patients’ medical records, many nursing home providers are not taking advantage of opportunities to reduce unnecessary care, honor the patient’s wishes and decrease health care costs.

According to Colleen Galambos, a professor at the university and the study’s lead author, the findings show a need for health care providers to designate a special section in medical records for advance directives. In addition, she suggested nursing home staff should be reminded about the necessity of checking directives.

“In the nursing home setting, some providers use aggressive end-of-life care, even if it is not in a person’s best interest or against a resident’s wishes,” Galambos said in a statement. “There is no reason for adults not to have an advance directive, and most nursing home residents should have an advance directive on file to ensure that they receive the type of end-of-life care they desire.”

Advance directives are legal documents that allow a person to choose how they want certain health care decisions to be made in the event of a serious injury or illness that renders them incapable of making such decisions for themselves. They outline preferences related to end-of-life care and provide a means avoid interventions that are unwanted or of limited benefit.