Journal of aging and health
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The aim of this study is to conduct a systematic review of the published research to examine the extent, nature, and risk factors of mortality due to physical restraint use. ⋯ Physical restraint is associated with deaths in nursing home residents. Further research is needed to investigate alternative interventions to restraint use.
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Although advance directives for health care are widely advocated, usage rates among the elderly are low. Reported is a study testing comparative educational strategies to increase the use of advance directives among elderly persons ages 65 to 93. Follow-up interviews (n = 293) with intervention participants and controls showed that only 1 of 6 different strategies increased use. ⋯ Most intervention participants preferred to defer to family surrogates and avoid executing advance directives. Level of education was a factor in use. Proposed is a restructuring of the advance directives process to accommodate elderly persons' wishes to authorize family members for surrogate health decision making, a policy that would assist the majority of people, including those who either wish to avoid or fail to execute advance directives.