2. 70% of Americans say they would prefer to die at home yet only about 25% of them do. Half of Americans die in hospitals and the remaining 25% die in long term care. (CDC, 2005) The authors...

2. 70% of Americans say they would prefer to die at home yet only about 25% of them do. Half of Americans die in hospitals and the remaining 25% die in long term care. (CDC, 2005) The authors Fagerlin and Sneider (2004) make strong arguments against the effectiveness of advance directives, yet in my experience these are still stressed in every aspect of health care.
Discuss evidence based strategies that can improve the experience for people who are at the end of life.  Please use two scholarly resources published I the last two years to support your answer.

Expert Answers
jimjimjimmy eNotes educator| Certified Educator

In the article titled, "Efficacy of advance directives in a general hospital," the authors state that from all the deaths observed in a given year at a general acute care hospital, only 22% of the patients who were included in their study had an advance directive. Out of that percentile (22%), only 50% of the patients studied actually met the conditions of their advance directive, and out of that percentile (50%), only 49% of the patients were actually influenced by the directives outlined by their advance directive. Therefore, out of 602 patients, only 5% were actually influenced by the conditions of a advance directive, a fact which indicates that a) advance directives are not entirely common in the US and b) advance directives are not always applicable, despite being stressed in every aspect of healthcare. To improve the experience of people who find themselves at the end of their life, the average person should actively promote out-of-hospital monitoring and treatment followup as a means to promote individualized and person-centered care (Lindecrantz). Indeed, in the article titled, "Attitudes among healthcare professionals towards ICT and home follow-up in chronic heart failure," the authors found that "a majority of healthcare professionals...are positive to both current and future use of ICT tools in healthcare and home follow-up," thereby indicating the lack of knowledge and/or interest from the general population in regard to these tools.