Matthijs P S van Wijmen1, H Roeline W Pasman2, Guy A M Widdershoven3, Bregje D Onwuteaka-Philipsen2. 1. Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, The Netherlands. Electronic address: eol@vumc.nl. 2. Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, The Netherlands. 3. Department of Medical Humanities, EMGO Institute for Health and Care Research, VU University Medical Center, The Netherlands.
Abstract
OBJECTIVE: What are motivations of owners of an advance directive (AD) to draft an AD, what do they aim for with their AD and do they communicate about their AD? METHODS: Written questionnaires were sent to a cohort of people owning different types of ADs (n=5768). A purposive sample of people suffering from an illness was selected from the cohort for an in-depth interview (n=29). RESULTS: About half of our population had no direct motivation to draft their AD. Most mentioned motivation for the other half was an illness of a family member or friend. Many different and specific aims for drafting an AD were mentioned. An often mentioned more general aim in people with different ADs was to prevent unnecessary lengthening of life or treatment (14-16%). Most respondents communicated about having an AD with close-ones (63-88%) and with their GP (65-79%). In the interviews people gave vivid examples of experiences of what they hoped to prevent at the end of life. Some mentioned difficulties foreseeing the future and gave examples of response shift. CONCLUSION: ADs can give directions to caregivers about what people want at the end of life. PRACTICE IMPLICATIONS: ADs have to be discussed in detail by their owners and caregivers, since owners often have specific aims with their AD.
OBJECTIVE: What are motivations of owners of an advance directive (AD) to draft an AD, what do they aim for with their AD and do they communicate about their AD? METHODS: Written questionnaires were sent to a cohort of people owning different types of ADs (n=5768). A purposive sample of people suffering from an illness was selected from the cohort for an in-depth interview (n=29). RESULTS: About half of our population had no direct motivation to draft their AD. Most mentioned motivation for the other half was an illness of a family member or friend. Many different and specific aims for drafting an AD were mentioned. An often mentioned more general aim in people with different ADs was to prevent unnecessary lengthening of life or treatment (14-16%). Most respondents communicated about having an AD with close-ones (63-88%) and with their GP (65-79%). In the interviews people gave vivid examples of experiences of what they hoped to prevent at the end of life. Some mentioned difficulties foreseeing the future and gave examples of response shift. CONCLUSION: ADs can give directions to caregivers about what people want at the end of life. PRACTICE IMPLICATIONS: ADs have to be discussed in detail by their owners and caregivers, since owners often have specific aims with their AD.
Authors: Matthijs P S van Wijmen; H Roeline W Pasman; Jos W R Twisk; Guy A M Widdershoven; Bregje D Onwuteaka-Philipsen Journal: PLoS One Date: 2018-12-18 Impact factor: 3.240
Authors: Kirsten Evenblij; H Roeline W Pasman; Agnes van der Heide; Trynke Hoekstra; Bregje D Onwuteaka-Philipsen Journal: BMC Med Date: 2019-02-19 Impact factor: 8.775
Authors: Marina R Ekkel; Marja F I A Depla; Els M L Verschuur; Ruth B Veenhuizen; Cees M P M Hertogh; Bregje D Onwuteaka-Philipsen Journal: BMC Med Ethics Date: 2022-10-10 Impact factor: 2.834