Advance directives: A social work initiative to increase participation

This article compared data on 200 patients at a large urban hospital on a number of demographic variables to distinguish clients who initiated an advance directive from those who declined. To better understand why some respondents refused, a telephone survey was conducted. As a result of the survey, an educational intervention was initiated in the walk-in clinic area. A social work student provided information and assisted with the completion of the forms. An ambulatory care setting was chosen assuming that, when patients are less ill, they may be better able to absorb the information on advance directives. As a result of the educational intervention, 66% of the respondents approached initiated an advance directive. Those that declined were called 2 weeks later, and 80% gave responses indicating they were making an informed decision. The findings clearly demonstrate that an educational intervention increases the percentage of individuals who initiate an advance directive.