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04/08/2014

Advance Directives & Nursing Home Stays Associated with Less Aggressive End-of-Life Care for Patients with Severe Dementia

A new study in Health Affairs shows some material benefits of advance directives:  “Advance Directives and Nursing Home Stays Associated with Less Aggressive End-of-Life Care for Patients with Severe Dementia.”


The authors found that that nearly 30 percent of patients with severe dementia remained in the community until death. Among those patients, having an advance directive in the form of a living will was associated with significantly less aggressive care at the end of life, compared to similar patients without an advance directive.

  • Medicare spending ($11,461 less per patient)
  • Likelihood of in-hospital death (17.9 percentage points lower)
  • Use of the intensive care unit (9.4 percentage points lower)

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