BARRIERS TO OBTAINING ADVANCED DIRECTIVES

Barriers to Obtaining Advanced Directives

Contents

Introduction4

Potential Benefits of Advance Directives4

Possible Limitations of Advance Directives5

Subjects with Advanced Directives5

Literature Review7

Factors of Relevance for an Agent9

Deviation from the Directives9

Consulting the Healthcare Team10

Palliative Care & Advance Directives11

Components of a Directive12

Mandatory Guidelines for Doctors and Relatives14

Patient Consent and Refusal of Care16

The Scope & Duration of Advance Directives16

Methodology18

Research Design19

Overview of the Study- Prerequisites & Past Researches20

Qualitative Research Methodology21

Hypotheses21

Selection of Human Participants22

Sample Size & Demographics of Participants22

Variables23

Independent Variable(s)23

Dependent Variable(s)24

Research Question24

Chosen Medical Facility- Maimonides Medical Center24

Research Instruments Used24

MOLST- Medical Orders for Life Sustaining Treatment25

Procedure26

Review of Literature for the Study26

Major Issues in Research27

Time Frame of the Research27

Ethical Considerations & Credibility of Research27

Limitations to the Research Design29

Protection of Human Participants29

Data Analysis31

How Data was Collected31

Intended Variables of the Study32

What Methods were Used32

Convenience Sampling32

Interview33

Review of Articles on Advanced Directives33

Sample Size & Demographics of Participants34

Developing Questions35

Analysis of Findings35

Data Reliability & Accuracy36

Discussion on Findings36

Limitations of the Study & Future Research37

Conclusion38

References40

Appendix I44

Appendix II45

Appendix III49

BARRIERS TO OBTAINING ADVANCED DIRECTIVES

In this research paper, we intend to study the major barriers to obtaining advanced directives. Advanced directives have become a serious concern in medical care. Our prime focus in studying advanced directives was on the data obtained by Maimonides Medical Center. Our research paper will begin with a thorough identification of the concept, variables associated with it, its prevalence and importance.

A qualitative study was conducted to adequately answer our research question. A qualitative analysis allowed us to explore the topic of our research and also expanded the existing knowledgebase on the topic. In order to obtain credible and relevant information on advanced directives; a qualitative interview was also conducted on the chosen participants. The interviews allowed us to identify the major barriers to obtaining advanced directives and the existing loopholes in the system.

Introduction

Advance directives for health care are documents that summarize the decisions on the treatment of patients that they entrust to others in the event that they become unable to communicate or make decisions for themselves (Heiman, Bates, Fairchild, Shaykevich, & Lehmann, 2004; Spoelhof & Elliott, 2012). These documents are sometimes called living wills. They exist in most provinces and territories of laws that recognize the right of patients to make decisions about their own care and treatment.

Potential Benefits of Advance Directives

Writing an advance directive encourages the patient to reflect on their values ??in terms of treatment and quality of life and make them known (Spoelhof & Elliott, 2012; Brown, Beck, Boles, & Barrett, 1999). The patient may feel less anxious knowing that their wishes will be respected when he is no longer able to make their own decisions. Members of the family may feel relieved not to have to make some tough decisions, or at least better placed to make decisions respecting the patient's wishes (Cugliari, Miller, & Sobal, 1995; Jezewski, Meeker, Sessanna, & Finnell, 2007). Conflicts could be mitigated among potential decision makers since many decisions have already been taken by the patient.

Possible Limitations of Advance Directives

The patient may change his mind about the treatment options available to him gradually as ...