Journal of Regional Medical Campuses

Advance Care Planning and Advance Directives Completion of Elderly Patients at a Rural Health Clinic on a Regional Medical Campus

Sarah Irvin

West Virginia University School of Medicine, Eastern Division

Melissa McGowan

West Virginia University School of Medicine, Eastern Division

Adrienne Zavala MD

West Virginia University School of Medicine, Eastern Division

DOI: https://doi.org/10.24926/jrmc.v3i2.2221

Keywords: Advanced care planning, advance directives, medical power of attorney, living will, geriatric, geriatric end of life planning, end of life planning, rural medicine, post form, MPOA, physician order for scope of treatment

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Abstract

Advance care planning is the shared decision-making process between physicians, patients, and families regarding the patient’s preferences for end of life care. These conversations increase compliance with patient wishes, decrease hospitalizations, increase deaths in patient’s preferred location, and decrease depression in surviving family members³. Even though there is proven benefit from advance care planning, these discussions are often overlooked. The purpose of this study is to evaluate rates of advance care planning and advance directive completion rate of 245 geriatric patients at our rural health clinic training site. We searched the electronic medical record to determine the number of patients who were asked about advance directives, stated they had a living will or medical power of attorney (MPOA), and had a living will or MPOA scanned into their chart. Out of the study population, 45% of patients stated they had some form of advanced directives. Of these patients, 22% and 25% had a living will and MPOA scanned into their chart, respectively. This study demonstrates the need for detailed discussion about advanced care planning with patients and additional follow-up to ensure documentation is readily available.  

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Author Biography

Adrienne Zavala MD, West Virginia University School of Medicine, Eastern Division

Adrienne Zavala is Assistant Dean of Student Services , Family Medicine Clerkship Co-Director, and core faculty in the Rural Family Medicine program at WVU School of Medicine's Eastern Campus. She has presented at AAFP's STFM and PDW conferences on topics including nutrition curriculum, cultural competency, clinic team huddling, global health rotations, and opiate management education. She practices and teaches full spectrum inpatient and outpatient Family Medicine at a Rural Health Clinic in the Easten Panhandal of West Virginia.