Brief Communication: The Relationship between Having a Living Will and Dying in Place

Abstract

Living wills are associated with dying in place rather than in a hospital. This implies that previous research examining only people who died in a hospital suffers from selection bias. During advance care planning, physicians should discuss patients' preferences for location of death.

Can Primary Care Visits Reduce Hospital Utilization Among Medicare Beneficiaries at the End of Life?

“…However, despite some evidence regarding improved quality, neither strategy clearly reduces costs for elderly Medicare beneficiaries [4][5][6][7] . Continuity of care has been associated with patients and their families experiencing a "higher quality death" 8 , with fewer emergency department visits for cancer patients 9 , increased patient satisfaction, increased adherence to recommended care, and less duplicate testing [10][11][12][13] .…”

Update in Palliative Care - 2011

“…16 Recently, studies have shown that advance directives are associated with patients receiving less lifesustaining treatment and of dying at home vs. dying in a hospital, 17,18 but it was unclear if these outcomes were consistent with patient wishes. Furthermore, it has never been determined how often patients are placed in a circumstance where advance directives could guide care.…”

Diretivas antecipadas de vontade: benefícios, obstáculos e limites

“…Estudos mais antigos revelaram que os mesmos tinham efeito mínimo nas decisões de impedir ou remover o cuidado [41][42][43][44][45] e pouco contribuíam para aumentar a consistência do cuidado recebido e o desejo do paciente 46 . Estudo mais recente demonstrou que pacientes com DAV estão menos propensos a receber tratamento de suporte de vida ou de morrer no hospital 47 , mas ainda não se tem certeza se os resultados são consistentes com os desejos dos pacientes. Estudo prospectivo concluiu que os desejos previamente expressos eram seguidos em 75% dos casos, independentemente da existência de uma DAV…”