Authors' objectives: End-of-life care decisions for the elderly have become increasingly important because of an aging population. An advance directive (AD) has been endorsed as a means for individuals to guide care before a possible future period of decision incapacity. The aims of this review are: 1) To examine the research evidence on the effectiveness of different methods for the delivery and completion of ADs; 2) To seek information regarding the local use of ADs in Alberta.

Authors' recommendations: The optimal method to increase discussions with older persons about end-of-life health care issues and the completion of written directives depends upon various factors such as setting, target population, and the availability of resources. Provision of written materials in addition to an interactive seminar appeared to significantly increased AD completion rates compared to provision of written materials only. A comprehensive and time intensive education program that included both competent elderly persons and family members of incompetent persons increased AD completion rate by at least 45% but the results can not be compared to other studies due to the difference in study design and reporting. The best-qualified professionals to deliver AD programs may be determined by the methods used for delivery, the complexity of the ADs, settings, and target populations. The Personal Directive Act in Alberta does not require health care professionals to enquire about personal directions nor is there a provincial policy. Hence Regional Health Authorities may choose to implement customized programs. Implementing a provincial directive program that is well established in one province needs to take into account the differences in the provincial legislations.

Authors' methods: Systematic review

Project Status: Completed

Year Published: 2004

URL for published report: https://www.ihe.ca/advanced-search?type=1020

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Institute of Health Economics

Contact Address: 1200, 10405 Jasper Avenue, Edmonton, Alberta, Canada, T5J 3N4. Tel: +1 780 448 4881; Fax: +1 780 448 0018;

Contact Name: djuzwishin@ihe.ca

Contact Email: djuzwishin@ihe.ca

Copyright: <p>Alberta Heritage Foundation for Medical Research (AHFMR)</p>