Facts
All adults should participate in ACP regardless of age or health status because accidents and illness can happen to anyone, any age, anywhere. Without an advance directive, doctors will turn to your family and friends to guide decisions for your medical care. Do they know what you would want? Have you talked about it with them? ACP helps to support your decision maker, family, and medical care team to make the right choices for you during an emergency. It is much easier to make good choices for emergency situations when you are not actually in a crisis, especially a life-threatening crisis. ACP is about much more than end-of-life conversation. It is also about personal values, goals of care, and quality of life.
Benefits
Benefits of ACP have been identified as care consistent with one’s values, improved quality of life at the end-of-life (EOL), reduced stress and burden on the surrogate, decreased demand for life-sustaining treatments, reduced hospitalizations, and increased use of palliative, hospice, and out-of-hospital care. Benefits for young people engaging in ACP include empowerment, better relationships, and successful health care communications. Additional benefits include increased EOL discussions between patients, family, and healthcare providers clarifying patient choices, ensuring concordance between these choices and EOL care received, and preventing unwanted EOL treatments.
Barriers
Research with young adults has identified a lack of knowledge to be a primary barrier to participating in ACP and completing ADs with the majority of wanting to know more. Age, race, ethnicity, gender, education, and income have all been associated with engagement in ACP. Older, white, non Hispanic, college educated women in higher SES account for the most participation in ACP. Healthy adults of any age, lower health literacy, and higher levels of religiosity are less likely to participate. Those who have experienced the death of a loved one or participated in EOL care planning have higher levels of engagement in ACP.