老年学と老年医学の研究

概要

Rethinking the Scope of Advance Care Planning for Older Adults

Eva Kahana

With the rapid growth of the older population globally, improving health care during the final period of life has become a key challenge for both palliative care and for geriatrics . The medical literature has focused on relieving suffering of elderly patients who are facing serious and life limiting illness near the end of life. The Patient Self- Determination Act in the US took affect in 1991 and has called for enhancing patient involvement in end-of-life decision making through completion of advance directives that can limit invasive medical care at the end of life. However, older patients who are still in reasonably good health show little interest and not likely to follow recommendations for completing advance directives. Furthermore, even when directives have been completed, there is frequent disregard for patients’ wishes.