New directions for policy and practice

Talking with loved ones about their preferences for care at the end of life, designating a proxy in a durable power of attorney for health care, and documenting conversations in a living will are important activities of advance care planning in which too few Americans engage. Even when such advance directives exist, too often they cannot be found, or health care workers misunderstand or disregard them. One result is that the care outlined in the directive may not be consistent with the care delivered. For more about the strengths and weaknesses of advance directives, see page 4. New Directions in Policy and Practice Issue 23, March 2005 Focus: Advance Care Planning—III Initiatives State in End-of-Life Care