Studies find lower rates of advance directive use among certain nursing home resident populations

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Letter: Assisted living group pushes for industry involvement to prevent 'pension poaching'
Letter: Assisted living group pushes for industry involvement to prevent 'pension poaching'

Mentally ill and black nursing home residents are less likely to have advance directives compared to their white and mentally healthy counterparts, according to two new studies.

Researchers from the University of Iowa and the Iowa City Veterans Affairs Medical Center found that 57% of residents with serious mental illnesses had advance directives. This compares to 68% of residents with no mental illness. This study was published in the January issue of the journal Psychiatric Services. Researchers reviewed residents with four different types of advance directives, including do-not-resuscitate orders; do-not hospitalize orders; living wills; and restrictions on feeding tubes, medications or other treatments. Almost two-thirds of nursing home residents have advance directives, which are legal documents that grant friends or family members to make end-of-life decisions when the resident cannot.

A different study found that black nursing home residents are less likely use any form of advance directive compared to white residents. But rates fare better in hospice care, according to the Centers for Disease Control and Prevention. In hospice, 80% of blacks and 89% of whites have directives, according to the study.