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. 1996 Dec;42:2413–2420.

Creating a living will. Experience at a multilevel geriatric facility.

D Levitt 1, M Gordon 1
PMCID: PMC2146845  PMID: 8969859

Abstract

PROBLEM: How to ensure that residents of a multilevel long-term care facility are able to indicate treatment preferences for the future (when they will be unable to participate in decision making). OBJECTIVE OF PROGRAM: To review the methods used to create a "living will" document suitable for a long-term care population that can be used as a guide and template for other long-term care populations. MAIN COMPONENTS OF THE PROGRAM: The process includes gathering information, developing possible models, designing the document, the review process, and implementing the document. CONCLUSIONS: Developing a living will document is not a simple process. The design should suit the population for whom the document is developed. Primary care physicians, other health care providers, and clergy should provide input.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Annas G. J. The health care proxy and the living will. N Engl J Med. 1991 Apr 25;324(17):1210–1213. doi: 10.1056/NEJM199104253241711. [DOI] [PubMed] [Google Scholar]
  2. Choudhry N. K., Ma J., Rasooly I., Singer P. A. Long-term care facility policies on life-sustaining treatments and advance directives in Canada. J Am Geriatr Soc. 1994 Nov;42(11):1150–1153. doi: 10.1111/j.1532-5415.1994.tb06980.x. [DOI] [PubMed] [Google Scholar]
  3. Cox D. M., Sachs G. A. Advance directives and the patient self-determination act. Clin Geriatr Med. 1994 Aug;10(3):431–443. [PubMed] [Google Scholar]
  4. Danis M., Southerland L. I., Garrett J. M., Smith J. L., Hielema F., Pickard C. G., Egner D. M., Patrick D. L. A prospective study of advance directives for life-sustaining care. N Engl J Med. 1991 Mar 28;324(13):882–888. doi: 10.1056/NEJM199103283241304. [DOI] [PubMed] [Google Scholar]
  5. Emanuel L. L., Danis M., Pearlman R. A., Singer P. A. Advance care planning as a process: structuring the discussions in practice. J Am Geriatr Soc. 1995 Apr;43(4):440–446. doi: 10.1111/j.1532-5415.1995.tb05821.x. [DOI] [PubMed] [Google Scholar]
  6. Emanuel L. L., Emanuel E. J. The Medical Directive. A new comprehensive advance care document. JAMA. 1989 Jun 9;261(22):3288–3293. doi: 10.1001/jama.261.22.3288. [DOI] [PubMed] [Google Scholar]
  7. Gordon M., Singer P. A. Decisions and care at the end of life. Lancet. 1995 Jul 15;346(8968):163–166. doi: 10.1016/s0140-6736(95)91215-0. [DOI] [PubMed] [Google Scholar]
  8. Hughes D. L., Singer P. A. Family physicians' attitudes toward advance directives. CMAJ. 1992 Jun 1;146(11):1937–1944. [PMC free article] [PubMed] [Google Scholar]
  9. Loewy E. H., Carlson R. W. Talking, advance directives, and medical practice. Arch Intern Med. 1994 Oct 24;154(20):2265–2267. [PubMed] [Google Scholar]
  10. Luptak M. K., Boult C. A method for increasing elders' use of advance directives. Gerontologist. 1994 Jun;34(3):409–412. doi: 10.1093/geront/34.3.409. [DOI] [PubMed] [Google Scholar]
  11. Meier D. E., Gold G., Mertz K., Taylor B., Cammer-Paris B. E., Seckler A., Mulvihill M. Enhancement of proxy appointment for older persons: physician counselling in the ambulatory setting. J Am Geriatr Soc. 1996 Jan;44(1):37–43. doi: 10.1111/j.1532-5415.1996.tb05635.x. [DOI] [PubMed] [Google Scholar]
  12. Molloy D. W., Guyatt G. H. A comprehensive health care directive in a home for the aged. CMAJ. 1991 Aug 15;145(4):307–311. [PMC free article] [PubMed] [Google Scholar]
  14. Pellegrino E. D. Nonabandonment: an old obligation revisited. Ann Intern Med. 1995 Mar 1;122(5):377–378. doi: 10.7326/0003-4819-122-5-199503010-00010. [DOI] [PubMed] [Google Scholar]
  15. Quill T. E., Cassel C. K. Nonabandonment: a central obligation for physicians. Ann Intern Med. 1995 Mar 1;122(5):368–374. doi: 10.7326/0003-4819-122-5-199503010-00008. [DOI] [PubMed] [Google Scholar]
  16. Robertson G. S. Making an advance directive. BMJ. 1995 Jan 28;310(6974):236–238. doi: 10.1136/bmj.310.6974.236. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Schneiderman L. J., Teetzel H. Who decides who decides? When disagreement occurs between the physician and the patient's appointed proxy about the patient's decision-making capacity. Arch Intern Med. 1995 Apr 24;155(8):793–796. doi: 10.1001/archinte.155.8.793. [DOI] [PubMed] [Google Scholar]
  18. Silverman H. J., Tuma P., Schaeffer M. H., Singh B. Implementation of the patient self-determination act in a hospital setting. An initial evaluation. Arch Intern Med. 1995 Mar 13;155(5):502–510. [PubMed] [Google Scholar]
  19. Virmani J., Schneiderman L. J., Kaplan R. M. Relationship of advance directives to physician-patient communication. Arch Intern Med. 1994 Apr 25;154(8):909–913. [PubMed] [Google Scholar]

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