Caregivers and advance directives: Special circumstances or common ground?

Rene P Laje, Fordham University


A review of the literature on end-of-life care decision-making demonstrates that it is a complex and evolving subject. The Patient Self-Determination Act of 1990 is a political attempt to address end-of-life care issues, however, readiness to communicate about death and dying has yet to be addressed. Research shows that people expect their families to make end-of-life decisions for them, but often do not have their wishes formally written down and have not discussed their wishes with their loved ones, regardless of their health. Among people who have Alzheimer's disease, which is a terminal illness, research is lacking on the factors related to their caregivers' perception of and use of advance directives. Social workers are in a unique position at this time to advocate and assist in advance directive discussions, which can lead to greater communication among the patient, family and physician. Studies show that there are several factors related to the completion of advance directives, however, underlying psychosocial issues have yet to be revealed. This was a study conducted to identify factors related to the possession of advance directives among caregivers of people with Alzheimer's disease. The significant predictors of advance directive completion by caregivers were age and caring for someone who also possesses an advance directive.

Subject Area

Social work|Nursing

Recommended Citation

Laje, Rene P, "Caregivers and advance directives: Special circumstances or common ground?" (2001). ETD Collection for Fordham University. AAI3005918.