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IUPUI To Study Living Wills Vs. Patient Wishes

Ken Mayer

IUPUI will take a first-of-its-kind look at whether living wills adequately reflect patients' wishes.

IU nursing professor Susan Hickman is leading a four-year study of the advance directives completed by nursing home patients or their health care representatives. She says it's unclear how often those directives are updated.

Hickman says ideally, advance directives should be reviewed regularly.

“It should be looked at whenever there’s a change in that person’s medical condition,” Hickman says. “If they go to the hospital, there should be a discussion about whether those orders still reflect their preferences.”

In some cases, a change in a patient's medical condition or other circumstances might warrant a revision, but patients may either not think about returning to it or be reluctant to revisit a traumatic conversation.

Hickman theorizes some people base their advance directives on bad information.

“Somebody did a study, years ago, and found that on T.V., about 75-percent of the time, people survive resuscitation attempts,” Hickman says. “The reality is, in the hospital setting, the survival rates are somewhere around 17-percent.”

Researchers will interview more than 300 patients and their representatives to assess whether advance directives adequately reflect patients' wishes, what factors influence their willingness to update the documents, and how the process could be improved.

The project is funded by a $2-million grant from the National Institute of Nursing Research.

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