Increasing Awareness and Knowledge of Advance Directives in the Healthy Older Adult Community

End-of-life treatment decisions have long been debated among healthcare providers, policy makers, and the public. Historically, physicians made end of life decisions based on the assumption professionals were acting in the patient's "best interest". With advancements in medical technology, patients have been living longer with outcomes not always ideal for the patient or their family. Well publicized cases in the 1970s and 1980s brought national attention to advance care planning (ACP) and the concept that adults can make decisions about the type of medical care they can receive in the future. In 1990, Congress passed the Patient Self Determination Act, which required all federally funded hospitals and nursing homes to provide patients with the opportunity to complete an advance directive (AD). Unfortunately, despite legislation, as well as professional and public endorsement of ADs, 70% of Americans have not formally expressed their wishes for health care at the end of life Although ADs have been used primarily in persons with terminal illness, studies suggest ADs should be completed when individuals are in good health and mentally competent. Primary care providers are in an ideal position to educate patients on ADs and to provide them with the tools needed to engage in ACP. Unfortunately, conversations regarding ADs do not routinely take place. ADs are therefore underutilized and poorly understood in the healthy older adult population. ADs are beneficial in a variety of ways. They reduce healthcare costs related to end of life care, increase the quality of life of a dying patient, place decision-making authority back into patient's hands, and create a sense of control over one's health care plan, promoting patient autonomy. The purpose of this scholarly project was to increase knowledge in the healthy older adult community regarding ADs to promote discussion between the healthy older adult and their primary care provider. Dissemination of information at a local level was achieved through a workshop on ADs at four senior centers across Salt Lake County. A fact sheet and checklist were also created to promote contemplation and preparation of ACP. Dissemination of information to a wider audience was achieved through submission of an article for publication in several lay journals. The one-page article regarding why ACP is important was submitted to AARP the Journal, Lady's Home Journal, Vital!, Boom!, and Reader's Digest. Increasing the older community's awareness and knowledge of ADs is the pivotal first step in a patient's willingness to engage in ACP.