Study Finds Elderly Patients Lack Decision-Making Capacity at Death

A University of Michigan study that was recently published in the New England Journal of Medicine finds that more than one in four elderly Americans lacked the capacity to make their own medical care decisions at the end of life. The study of over 3,700 people found that those who had advance directives received the care they wanted most of the time.  Of the subjects studied, 61 percent had advance directives. Of those, more than 90 percent requested either limited or comfort care at the end of life. Among those who needed decisions made, but couldn’t make them themselves, 83% who had requested limited care and 97% who had requested comfort care, received the care that was in line with their wishes.

“Prior to our study, no one knew how many elderly adults might need others to make complex medical decisions on their behalf at the end of life,” says Maria Silveira, M.D., M.P.H., physician scientist at the VA Ann Arbor Healthcare System’s Clinical Management Research and assistant professor of Internal Medicine at the University of Michigan.. “Our research shows that a substantial number of older adults need someone else to make decisions about whether aggressive, limited, or comfort care should be provided at the end of life.”