A Community Engagement Model to Drive Advance Directive Discussion and Completion

Kristin L. Hines, Elyse Taylor, Emily Hollingsworth, Shana Rhodes and James S. Powers*

A Community Engagement Model to Drive Advance Directive Discussion and Completion.

Advance directives describe individuals’ preferences for life-sustaining treatments and/or surrogate decision-makers, to help avoid unwanted, burdensome treatments at the end-of-life. However, only 36.7% of adults have completed an AD. There is growing interest in adopting a public health approach to end-of-life care, including ADs. We describe the experience of Honoring Choices Tennessee which developed a pilot program, Advance Directives at Work in Tennessee, to enhance AD completion by the general public workforce.

The AD@WorkTN initiative targeted adults in the Tennessee workforce by engaging human resource leaders in educational presentations. In April 2021 a HCT sponsored PBS documentary on advance care planning was produced with statewide distribution.

Over a 2-year period, 58 workshops were conducted for 260 human resources leaders representing 958 businesses. As a result, 23 businesses have included ADs as part of the employee benefit process. Additionally, a 2-year multifaceted public outreach campaign between 2019-21 has reached 2,950 employees and 958 businesses. Approximately 81,500 Tennessee viewers have seen the Public Broadcasting Service documentary on advance care planning.

AD@WorkTN is a promising model to promote integration of ADs into the employee orientation and benefits enrollment processes. Enhanced discussion and completion of ADs among employed individuals and enhanced public discourse such as podcasts and television productions may encourage intergenerational conversations about end-of-life care and documentation in healthcare records.

Palliat Med Hosp Care Open J. 2021; 7(1): 16-19. doi: 10.17140/PMHCOJ-7-143