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The Challenges States Face to Promote Advanced Care Planning

Posted on Friday, March 8, 2019 6:24 PM

According to a new study from the Government Accountability Office (GAO), states are attempting to promote advanced care planning in different ways, leading to confusion and access problems for patients and clinicians.
An advanced care directive is a written instruction recognized under state law that allows a patient’s wishes be known if they cannot speak for themselves. Advance care planning documents are most useful when they are part of a broader effort to plan end of life care, according to a report on the subject by the Institutes of Medicine, which also stressed the need for regular discussions among family and loved ones during the various stages of life and illness. These discussions can add context to the wording of an advanced care directive document.
The study showed that only 14 states have active registries of advanced care documents. Of these, some states administered the registry through a state agency and others contracted it out to an outside organization.
The GAO found two major problems to promotion of advance care planning:

1. a lack of understanding about advance care planning, including how to initiate conversations about advance care planning and how to complete and follow advance care planning documents;
2. ensuring access to completed documents.

Discussing end of life care with patients and family is a tough conversation to have, but it is important to persevere, so the patient’s wishes are in writing.


Source: NAHC


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