Decision-Making Ability and Advance Directive Preferences in Nursing Home Patients and Proxies

Abstract
We studied 39 nursing home patients and proxies to assess their decision-making capability and preferences regarding advance directives (ADs) or “living wills.” Most patients willingly stated preferences; over half opted to forego burdensome measures when death appeared imminent. Patients perceived as decisionally capable were more likely to forego life-sustaining measures than those of questionable capability. The vast majority of proxies disapproved of using life-sustaining measures, even in some cases with limited knowledge of patients' preferences.

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