The study by Silveira, Kim, and Langa examines the prevalence and outcomes of surrogate decision making in elderly Americans, focusing on the value of advance directives. Using data from the Health and Retirement Study, the researchers found that 42.5% of adults aged 60 and older required decision-making about medical treatment at the end of life, with 70.3% lacking the capacity to make these decisions. Among those who needed decision-making, 67.6% had advance directives, which were more likely to align with their preferences for care. Patients with living wills were more likely to request limited or comfort care, and 83.2% of those requesting limited care and 97.1% of those requesting comfort care received care consistent with their preferences. However, only 50% of patients who requested all care possible received it, despite a higher likelihood of receiving aggressive care among those who requested it. Subjects who had assigned a durable power of attorney for healthcare were less likely to receive all care possible or die in a hospital. The study concludes that advance directives are important tools for ensuring that patients' wishes are respected at the end of life, and that the healthcare system should support the use of these documents by providing time and resources for discussions about end-of-life care.The study by Silveira, Kim, and Langa examines the prevalence and outcomes of surrogate decision making in elderly Americans, focusing on the value of advance directives. Using data from the Health and Retirement Study, the researchers found that 42.5% of adults aged 60 and older required decision-making about medical treatment at the end of life, with 70.3% lacking the capacity to make these decisions. Among those who needed decision-making, 67.6% had advance directives, which were more likely to align with their preferences for care. Patients with living wills were more likely to request limited or comfort care, and 83.2% of those requesting limited care and 97.1% of those requesting comfort care received care consistent with their preferences. However, only 50% of patients who requested all care possible received it, despite a higher likelihood of receiving aggressive care among those who requested it. Subjects who had assigned a durable power of attorney for healthcare were less likely to receive all care possible or die in a hospital. The study concludes that advance directives are important tools for ensuring that patients' wishes are respected at the end of life, and that the healthcare system should support the use of these documents by providing time and resources for discussions about end-of-life care.