Prevalence of Having Advance Directives and a Signed Power of Attorney in Nova Scotia

Background: Advance directives are statements that allow a person to express his or her wishes for medical treatment in advance of needing it or to appoint someone else if they are unable to do so. Objectives: To estimate the prevalence of decedents having a documented advance directive (AD) and a signed enduring power of attorney (SPoA) and to determine the degrees to which characteristics of decedents and their informant and the care the decedent received were predictive of the decedents having a documented AD and a SPoA. Methods: A population-based mortality follow-back survey was conducted in Nova Scotia, Canada. Informants who were knowledgeable of a decedents' death were invited to participate in a telephone interview based on the After-Death Bereaved Family Member Interview. Regression analyses were used to assess factors that were predictive of having an AD or SPoA. Results: Overall, 56.3% of decedents had a documented AD, and 67.6% had an SPoA. Significant predictors of a decedent having a documented AD were their age, where they received the majority of their end-of-life care, whether they received specialized palliative care, whether they were aware they were dying, and the informant's age. Significant factors in predicting whether a person had a SPoA were whether the decedent received specialized palliative care, where they received the majority of their care, and the age and education level of their informant. Conclusion: These results may be used to better target and tailor future efforts to promote use of AD and SPoA.