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Healthy Older Adults' Execution of Advance Directives: A Qualitative Study of Decision Making

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Abstract:

In 1990, the U.S. Congress passed the Patient Self-Determination Act (PSDA), thus giving patients the first federal legislation to address right-to-die issues. Federal agencies receiving Medicare and Medicaid funding were mandated to give patients information about their legal rights to make decisions (through executing advance directives) about care, including the right to accept or refuse medical or surgical treatment. This qualitative study of healthy older adults (not in the midst of a health care crisis) looked at the factors that influenced these individuals to write advance directives. Three major themes emerged: Family Influences, Quality-of-Life Concerns, and Pragmatic Concerns. Understanding the factors that inspired these individuals to write advance directives may help nurses, physicians, other health care providers, and attorneys dialogue more effectively with patients regarding end-of-life experiences and choices.

Keywords: EXECUTION OF ADVANCE DIRECTIVES; GOOD DEATH; HEALTH CARE PROXY; NURSING ROLE IN IMPLEMENTATION OF PSDA; PATIENT SELF-DETERMINATION ACT; QUALITATIVE STUDY

Document Type: Research Article

Publication date: 2007-12-01

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