THE UTILIZATION OF THE DURABLE POWER OF ATTORNEY FOR HEALTH-CARE AMONG HOSPITALIZED ELDERLY PATIENTS

Objective: To explore the potential use of the durable power of attorney for health care (DPAHC), considerations in executing a DPAHC, and influences in making decisions related to it. Design: Interview with follow up. Setting: A teaching hospital. Subjects: 37 males, 60 females, aged 64-97. Methods: Interview of ninety-seven hospitalized patients and followup telephone interview of those who had not originally executed a DPAHC after 3 months. Patients were asked whom they would appoint as an agent for health care decisions, how this person was related to them, and why they chose this person. Patients' cognitive functioning and level of depression were assessed. Results: Most patients (65%) chose their closest relative to make health care decisions for them if they were unable to. Reasons for choosing this person included: the agent knew the patient best, was the closest relative, and was most accessible geographically. Over half of the participants had not discussed their feelings about health care decisions with anyone. Sixteen percent had previously executed a durable power of attorney for health care, and 46% said they intended to execute one. Executing a durable power of attorney for health care was associated with higher levels of cognitive functioning but not with level of depression. Conclusions: Both an understanding of advanced directives and a general outlook on matters of life and death seem to affect people's utilization of the DPAHC. The ability to execute a DPAHC and the choice of an agent are affected by individuals' interpersonal relations.