Advance Health Care Directive (AD) / Interesting Facts

Facts

• 15% of the U.S. economy is now devoted to medical care.



• 45 million people are not insured.



• 18,000 people die each year in the U.S. because they cannot financially access health care.



• The U.S. has fewer nurses per 1000 people than Switzerland, Norway, Luxembourg, or Canada



• 70% of Californians support the idea that “incurably ill patients have the right to ask for and get life-ending medication.” This is true for all religious and party affiliations. (Field Poll, February 2005).

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Advance Care Planning: Preferences for Care at the End of Life

• Fewer than 50 percent of the severely or terminally ill patients studied had an advance directive in their medical record.



• Patients who talked with their families or physicians about their preferences for end-of-life care: had less fear and anxiety. felt they had more ability to influence and direct their medical care, believed that their physicians had a better understanding of their wishes, and indicated a greater understanding and comfort level than they had before the discussion

The Agency for Healthcare Research and Quality's (AHRQ); http://www.ahrq.gov/research/endliferia/endria.htm

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End-of-life Care Often Begun Too Late: Study

• Researchers found that half of families who had lost someone to cancer thought that doctors had referred their relatives for palliative care too late. Palliative care attempts to relieve dying patients' physical symptoms and address their emotional needs, rather than strive for a cure.

MedlinePlus, Reuters Health, By Amy Norton, http://medlineplus.gov/

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Advance Directives Found Key to Reducing Stress for Families of Hospitalized Patients at the End of Life

• Researchers from the Oregon Health Sciences University report that stress levels have been measured as extremely high for family members who must decide whether or not life support should be withdrawn from relatives too incapacitated to decide for themselves. Reported levels of stress are twice as high as those due to other serious crises, such as ferry or construction disasters, or losing a home to fire.



• Stress was least severe when patients' written advance directives were available and most severe in the absence of written or verbal directives.

The National Institute of Nursing Research is a component of the National Institutes of Health, U.S. Department of Health and Human Services. http://www.nih.gov/

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Advance Directives Education Act of 2005

• Every year 2,500,000 people die in the United States. Eighty percent of those people die in institutions such as hospitals, nursing homes, and other facilities. Chronic illnesses, such as cancer and heart disease, account for 2 out of every 3 deaths.



• In January 2004, a study published in the Journal of the American Medical Association concluded that many people dying in institutions have unmet medical, psychological, and spiritual needs. Moreover, family members of decedents who received care at home with hospice services were more likely to report a favorable dying experience.



• In 1997, the Supreme Court of the United States, in its decisions in Washington v. Glucksberg and Vacco v. Quill, reaffirmed the constitutional right of competent adults to refuse unwanted medical treatment. In those cases, the Court stressed the use of advance directives as a means of safeguarding that right should those adults become incapable of deciding for themselves.



• A study published in 2002 estimated that the overall prevalence of advance directives is between 15 and 20 percent of the general population, despite the passage of the Patient Self-Determination Act in 1990, which requires that health care providers tell patients about advance directives.



• Competent adults should complete advance care plans stipulating their health care decisions in the event that they become unable to speak for themselves. Through the execution of advance directives, including living wills and durable powers of attorney for health care according to the laws of the State in which they reside, individuals can protect their right to express their wishes and have them respected.

Advance Directives Education Act of 2005, http://www.theorator.com/bills109/s570.html