%0 Journal Article
%T Advance Directives Revisited (2002 vs. 2023): Are We Closer to Uniformity?
%A Luck GR
%A Bautista A
%A Peters D
%A Attonito J
%A Fridman S
%A Sohmer J
%A Jacomino M
%J Gerontologist
%V 0
%N 0
%D 2024 Aug 10
%M 39126379
%F 5.422
%R 10.1093/geront/gnae103
%X <B>OBJECTIVE: </B>Advance directives (AD) are based on state-specific statutes that vary in structure, terminology, and options. This variability leads to inconsistent end-of-life (EOL) care for patients who have executed an AD in one state but fall ill in another state. This study revisits a 2002 article that identified considerable differences in ADs to determine whether ADs have become more uniform.<BR><B>METHODS: </B>ADs from all 50 states and the District of Columbia were examined to determine the frequency of document types and seven key issues. The results were = compared to the 2002 study using non-parametric approaches. Mean numbers of key issues were compared using t-tests and one-way ANOVA.<BR><B>RESULTS: </B>Consistent with 2002, three states in 2023 provide statutes for Health Care Power of Attorney (HCPOA). However, states offering a combined HCPOA, and living will (LW), deemed an advance directive for health care (ADHC), increased from 13 to 30. Between both studies, Long Term Care increased significantly in LW and ADHC, while Artificial Sustenance significantly increased in LW. Despite the rising prevalence of Alzheimer's in the United States, only 10% of states included this issue in 2023.<BR><B>CONCLUSIONS: </B>Despite evolving healthcare trends, minimal revisions have been made to ADs since 2002. This lack of uniformity can cause confusion regarding proper understanding of EOL wishes. The authors recommend that the Uniform Act for Advance Directives be revisited to promote greater uniformity in ADs and ensure that individuals' preferences are understood and respected across different states.