Dialysis patients' preferences for family-based advance care planning.

BACKGROUND

Most patients do not participate in advance care planning with physicians.

OBJECTIVE

To examine patients' preferences for involving their physicians and families in advance care planning.

DESIGN

Face-to-face interviews with randomly selected patients.

SETTING

Community-based dialysis units in one rural and one urban region.

PARTICIPANTS

400 hemodialysis patients.

MEASUREMENTS

Questions about whom patients involve in advance care planning, whom patients would like to include in this planning, and patients' reactions to state legislation on surrogate decision makers in end-of-life care.

RESULTS

Patients more frequently discussed preferences for end-of-life care with family members than with physicians (50% compared with 6%; P < 0.001). More patients wanted to include family members in future discussions of advance care planning than wanted to include physicians (91% compared with 36%; P < 0.001). Patients were most comfortable with legislation that granted their family end-of-life decision-making authority in the event of their own incapacity (P < 0.001).

CONCLUSION

Most patients want to include their families more than their physicians in advance care planning.