Advance Directives: Limitations to Completion

The number of elderly persons is expected to increase to 55 million by 2020, with the minority population increasing to 12.9 million, yet fewer than 30% of Americans have advance directives in place. Cultural values, religious beliefs, and family support systems are a few of the factors that influence or hinder the completion of advance directives. Health care provider perspectives regarding advance directives vary greatly with health care settings. Many primary care providers are reluctant to initiate conversations regarding advance directives for multiple reasons. Nurse practitioners cover more than 600 million office visits per year in the United States and are in a key position to educate, advocate, and assist in the completion of advance directives.