| Advance directives are documents that allow patients to communicate wishes with regard to medical care in advance of becoming incapable of expressing those wishes to medical professionals. Advance directives are a key component of the movement toward "patient-centered care," which emphasizes two-way communication between medical professionals and patients and provision of care that is closely tied to the patient's priorities. This paper builds on research on effective advance directive programs by investigating how these orders are translated to care received for nursing home residents. Using data from the 2004 National Nursing Home Survey, I focus on "do not hospitalize" and "feeding restrictions" advance directives, to examine how nursing home residents, all of whom would have received the opportunity to complete an advance directive upon admissions to the nursing home per Federal law, experienced care in relation to the wishes they expressed.;While I fully expect that the presence of an advance directive will have a substantive impact on the probability of corresponding medical care, it is important to examine the statistical significance of such a relationship. This is especially true in light of the programs taking root around the country, which emphasize specificity and explicitness in the writing of advance directives. Federal law guarantees individuals the right to accept or refuse medical treatment, and to have an advance directive in place. This paper seeks to examine the extent to which nursing home residents can expect this right to be fulfilled, and investigate ways that processes and procedures related to advance directives can be improved. |
