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Kaiser Health News recently reported that despite promotion to encourage end-of-life advance directives, only about a third of U.S. adults have them, according to a recent study published in Health Affairs.

That number is higher with people over 65 making advance directives, 45.6 percent compared to 31.6 percent. The difference between healthy people and those who were sick was much smaller, 32.7 percent compared to 38.2 percent.

The study did not incorporate any influence that may have occurred once the Medicare program began reimbursing physicians in January 2016 for counseling their patients about end-of-life care. The study found there are many reasons people do not want a living will.

“Many people don’t sign advance directives because they worry the are not going to get any care if they say they don’t want [cardiopulmonary resuscitation],” said senior study author Dr. Katherine Courtright, an instructor of medicine in pulmonary and critical care at the University of Pennsylvania. “It becomes this very scary document that says, ‘Let me die.’” But these living wills, which are legal documents, can be reinterpreted by family members or medical staff. For example, a person’s will may say they do not want to be put on a ventilator, but if it means going on a ventilator for a few days to recover from pneumonia, then many want to do that.

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It is important for each of us to complete an advance directive form and other medical forms. No matter your age, this simple step can help relieve much burden and guilt on those closest to us. These forms must be accessible and updated over time. Take the time to talk with your loved ones about decisions related to your care. Encourage your patients and their family members to do the same. Visit the Conversation Project to learn more. The site offers a wealth of resources, videos and tools to get started. Make the commitment today to learn more and begin the conversation.