Researchers from Flinders University in Adelaide recently completed an extensive survey of more than 3,000 households in South Australia to determine the prevalence of completion of advance directives (AD) and wills by people older than 15 years. The results were published in the Medical Journal of Australia.

“Advance directives have been championed as a remedy for providing evidence of the medical, financial, health care and lifestyle options a person would choose at a time when they may lack capacity for decision making,” the authors wrote.

Lead author Sandra L. Bradley, a PhD candidate with Flinders University, and the research team sought to discover both prevalence and sociodemographic determinants of completion of the four recognized legal ADs in South Australia, including enduring power of attorney [EPA] for finance, enduring power of guardianship [EPG] for health care/lifestyle, medical power of attorney [MPA] for medical treatment and anticipatory direction for end-of-life care) and wills.

“Demographic variables associated with completion or non-completion of these instruments were also investigated,” the authors wrote.

Data analyses was performed using weighted data and only weighted results were reported. From a total of more than 5,000 households contacted, 3,055 interviews were completed—a 60 percent response rate.

The results showed that financial documents were more likely to be completed than health care documents. Completion rates for ADs were highest in the 65 years and older age group, though there is still a large portion of older people not completing the documents.

Individuals between the ages of 18 and 45 were far less likely than others to complete AD documents. Patients between the ages of 45 and 64 were completing ADs, an occurrence the study team attributed to general practitioners and other professionals interacting more with patients and raising awareness.

“Given that rural and regional area of residence and non-married or non-working status were each associated with reduced odds of completing most ADs, GPs working in the country or in areas with a high proportion of non-married and non-working individuals might find it especially useful to promote the role of ADs and the value of identifying a trusted substitute decision maker to help with future decisions,” the authors concluded.