title: Living will completion in older adults.
abstract: BACKGROUND
  In December 1991, the Patient Self-Determination Act required health care institutions to provide incoming patients with information about living wills (LWs). Although LWs have been legalized in the majority of states, the number of people with a completed LW remains low. This study was designed to learn some of the reasons that so few people have an LW.
  
  
  METHODS
  With the use of the health belief model, a questionnaire was designed to characterize the group that already had a completed LW and to identify the barriers older adults perceive in their completion of an LW. Older adults (aged 65 to 90 years) who dined at 10 local nutrition sites were asked to participate. Of the 214 subjects with usable responses, 15% already had executed an LW, 66% planned to complete an LW, and 86% wanted to have an LW. By means of multiple regression and discriminant analysis, the characteristics that defined each group were statistically determined.
  
  
  RESULTS
  Two characteristics described those who already had an LW: they were highly educated and did not consider the LW form too long for its purpose. The older adults who planned to complete an LW identified two barriers impeding them: family issues and a need for assistance in completing the form. The majority of the older adults (61%) desired that their physicians initiate discussions with them about an LW.
  
  
  CONCLUSIONS
  Conclusions from these data yield recommendations for health care providers toward implementing the act; physician-initiated discussions, community programs, and available information and assistance are needed.
authors.affiliation: Duluth Family Practice Residency Program, MN.
authors.forename: K L
authors.initials: KL
authors.lastname: Stelter
authors.forename: B A
authors.initials: BA
authors.lastname: Elliott
authors.forename: C A
authors.initials: CA
authors.lastname: Bruno
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D016002:Discriminant Analysis; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033181:Information Dissemination; D016224:Living Wills / Q000706:statistics & numerical data*; D008297:Male; D015146:Midwestern United States; D010358:Patient Participation / Q000706:statistics & numerical data*; D012044:Regression Analysis; D011795:Surveys and Questionnaires