ADVANCE DIRECTIVE PREFERENCES - Comparing Medical-Social-Emotional vs. Medical-Based Approaches - Issue 2 - Healthcare insights

Sep 29, 2026

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This study examines U.S. community-dwelling adults’ preferences for and suggestions to improve two advance directive formats: medical-based documents (POLST/MOLST) and medical-social-emotional-based documents (Five Wishes), with attention to age-related differences. Adults completed a survey, using univariate analyses for directive-type preferences, bivariate analyses for age comparisons, and thematic analysis for recommendations. Young adults showed stronger preference for Five Wishes. Key recommendation themes included content, formatting, and no recommendations; POLST/MOLST feedback emphasized more detail, less jargon, less dense layout, and a more holistic end-of-life approach, while Five Wishes feedback suggested shortening the form, adding treatment questions, and improving usability.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Abstract

Study design and methods

Preference findings

Age-related patterns

Recommendations for improving POLST/MOLST

Recommendations for improving Five Wishes

Innovation in Aging, 2025, Vol. 9, No. S2 765 Abstract citation ID: igaf122.2600 ADVANCE DIRECTIVE PREFERENCES: COMPARING MEDICAL-SOCIAL-EMOTIONAL VS. MEDICAL-BASED APPROACHES Ashley Shayya1, Yuchi Young2, Yufang Tu3, Wan-Yu Chiu4, and Taylor Perre5, 1. Center for Human Services Research, University at Albany College of Integrated Health Sciences, Albany, New York, United States, 2. University at Albany College of Integrated Health Sciences, Albany, New York, United States, 3. North Dakota State University, Fargo, North Dakota, United States, 4. National Taiwan University, Zhongzheng District, Taipei, Taiwan (Republic of China), 5. Home Care Association of New York State, Albany, New York, United States This study explores adults’ preferences for and recommendations to improve medical-based (POLST/MOLST) and medical-social-emotional-based (Five Wishes) advance directives, with a focus on age-related differences. US community-dwelling adults completed a survey on advance directives. Univariate analyses were used to assess advance directive type preferences, bivariate analyses evaluated age differences, and a thematic analysis identified recommendations for improvement. Participants, particularly young adults, preferred the Five Wishes form over the POLST/MOLST. Three key themes emerged from participants’recommendations for improving the advance directives: content, formatting, and no recommendations. A greater proportion of participants shared content recommendations for the POLST/ MOLST and formatting recommendations or no recommendations for the Five Wishes form. For the POLST/MOLST, adults emphasized the need for more detailed descriptions, less medical jargon, less dense formatting, and an overall more holistic approach to end-of-life care. For the Five Wishes form, adults recommended shortening the form, adding more medical treatment questions, and altering the format of the wishes to be more user friendly. These recommendations to improve the POLST/ MOLST and Five Wishes form may be useful for advance directive creators and policymakers to consider when making future adaptations to these advance directives. Preferences for medical-social-emotional-based and medical-based advance directives should be considered by medical practitioners, policymakers, and public health professionals when promoting advance directives, especially among young adults.

FAQs

Which advance directive forms did participants prefer, and how did age relate to preferences?

Participants, especially young adults, preferred the Five Wishes form over POLST/MOLST. The study also identified age differences in directive-type preferences and recommendations.

What analytic methods were used to evaluate preferences and recommendations?

Univariate analyses assessed advance directive type preferences, bivariate analyses evaluated age differences, and thematic analysis identified recommendations for improvement.

What recommendations did adults make to improve POLST/MOLST and Five Wishes?

For POLST/MOLST, adults emphasized more detailed descriptions, less medical jargon, less dense formatting, and a more holistic end-of-life care approach. For Five Wishes, adults recommended shortening the form, adding more medical treatment questions, and making the wishes format more user friendly.

Sep 29, 2026

Upload by Mia