Date of Paper


Type of Paper

Clinical research paper

Degree Name

Master of Social Work (M.S.W.)


Social Work

First Advisor

Katharine Hill


Social Work


An advanced directive is a document used to communicate end-of-life treatment desires when a patient is incapacitated or determined to be incapable of making their own decisions. This study was conducted using secondary data analysis of data collected from a 2010 survey by the National Center for Family and Marriage Research. The sample utilized in this study included married and cohabitating couples between 45 and 64 years of age. This research analyzed the accuracy of couples’ perceptions of their partner’s end-of-life treatment wishes. Characteristics among those who have advanced directives in place were distinguished. Individuals are better able to predict their spouses’ end-of-life treatment wishes when they themselves were in poor health. Factors that contributed to a slightly higher percentage rate of participant’s ability to distinguish their spouse’s end-of-life treatment wishes included having a spouse appointed as durable power of attorney for health care and having discussed end-of-life treatment wishes with a spouse. Participants who reported dissatisfaction with their spouses’ listening were found to have slightly lower percentage rates of ability to predict their spouses’ end-of-life treatment wishes. These findings reveal that many Americans do not actually know the level of care their spouses would like to receive at the end of their lives. The findings suggest a need for social workers to assess if there is a disconnect between couples when it comes to understanding one another’s advanced directive contents. A disconnect in this vital communication may leave individuals receiving care they do not want, or not receiving care they would prefer.

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