Advance directives in palliative care-a new tool to improve the communication between patients and caregivers?

Int J Palliat Nurs. 2023 Jul 2;29(7):344-349. doi: 10.12968/ijpn.2023.29.7.344.

Abstract

Background: In palliative care, caregivers frequently act as surrogate decision-makers, but their knowledge of patients' preferences for end-of-life care is sometimes scarce and incorrect. Advance Directives might be a powerful communication tool to promote the dialogue between patients and caregivers.

Aims: This work aims to find evidence supporting the use of the Advance Directives documents by health practitioners as a communication tool to improve caregivers' capacity as health surrogates in palliative care.

Methods: A literature review was conducted in four databases-Medline, Web of Science, Scopus, and Cochrane to identify studies published until February 27th, 2021, analysing advance directive's use as a communication tool between palliative patients and their caregivers.

Findings: Of the 1251 papers screened, only one article met the defined criteria, presenting results statistically favourable to advance directive's use, although with the risk of significant bias.

Conclusions: Although the results seem promising, more studies are needed to validate this strategy scientifically.

Keywords: advance directives; communication; palliative care; surrogate.

Publication types

  • Review

MeSH terms

  • Advance Directives
  • Caregivers*
  • Communication
  • Decision Making
  • Humans
  • Palliative Care*