Healthcare providers contemplating advance directives in a serene hospice setting.

Advance Directives: Why Healthcare Providers Aren't Preparing for Their Own End-of-Life Care

Elliot Brynn in Health & Wellness December 2025 • 4 min read.

"A surprising number of hospice and healthcare professionals haven't completed their own advance directives, highlighting a critical gap in end-of-life care preparedness."

Imagine a world where everyone's end-of-life wishes are honored, where difficult decisions are made easier because there's a clear plan in place. Advance directives—legal documents outlining your healthcare preferences when you can't speak for yourself—are designed to make this a reality. But what happens when the very people who advocate for these documents, the healthcare providers themselves, haven't taken the time to complete their own?

A recent study published in The American Journal of Medicine sheds light on this surprising paradox. Researchers found that a significant percentage of healthcare providers, including those working in hospice care, haven't completed their own advance directives. This gap raises important questions about awareness, preparedness, and the factors influencing these critical decisions.

This article dives into the key findings of the study, explores the reasons behind this lack of completion, and discusses why it's so important for healthcare professionals to lead by example. Whether you're a healthcare provider, a caregiver, or simply someone interested in planning for the future, this information is vital for ensuring your end-of-life wishes are respected.

Why Aren't Healthcare Providers Completing Advance Directives?

Healthcare providers contemplating advance directives in a serene hospice setting.

The study revealed that a significant portion of healthcare providers have not completed an advance directive. This is particularly surprising given that many of these professionals work directly with patients facing end-of-life decisions. Several factors contribute to this gap:

Procrastination and avoidance play a significant role. Like many people, healthcare providers may put off thinking about their own mortality. The topic can be emotionally challenging, leading to delays in completing the necessary paperwork.

Lack of Knowledge: Some providers may not fully understand the specifics of advance directives or how to complete them.
Fear and Discomfort: Discussing end-of-life wishes can be emotionally difficult, leading to avoidance.
Time Constraints: Busy schedules can make it difficult to prioritize personal healthcare planning.
Beliefs and Values: Personal beliefs about death, dying, and medical intervention can influence decisions about advance directives.

The study also found that certain demographic factors influenced completion rates. Older individuals and those who were widowed or in domestic partnerships were more likely to have advance directives. White/Caucasian employees also showed statistically higher completion rates compared to other groups. These disparities highlight the need for targeted education and outreach efforts.

Taking Action: Bridging the Gap in End-of-Life Planning

The study underscores the importance of promoting advance directives among healthcare providers. By increasing awareness, providing education, and addressing the barriers to completion, we can empower these professionals to make informed decisions about their own end-of-life care. This not only ensures their wishes are respected but also sets a powerful example for patients and the wider community.

About this Article -

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Everything You Need To Know

What are advance directives and why are they important?

Advance directives are legal documents that outline your healthcare preferences if you become unable to communicate them yourself. These documents allow you to specify the medical treatments you want or don't want, ensuring your wishes are honored at the end of your life. They are crucial because they empower individuals to make their own healthcare decisions, even when incapacitated, and can ease the burden on family members during difficult times.

Why haven't many healthcare providers completed their own advance directives?

Several factors contribute to this. Procrastination, lack of knowledge about advance directives, fear and discomfort associated with discussing end-of-life wishes, time constraints due to busy schedules, and personal beliefs about death and medical interventions all play a role. Some healthcare providers may avoid thinking about their own mortality, leading to delays in completing these important documents.

What specific reasons, mentioned in the study, prevent healthcare providers from completing advance directives?

The study highlights several key obstacles. Many providers procrastinate due to the emotional challenge of contemplating their mortality. Some lack knowledge about the specifics of advance directives or how to complete them. Furthermore, fear and discomfort related to discussing end-of-life wishes, along with time constraints imposed by busy schedules, also act as barriers. Personal beliefs about death, dying, and medical interventions can also influence the decision to complete advance directives.

How do demographic factors influence the completion of advance directives among healthcare providers?

The study found that older individuals, those who were widowed or in domestic partnerships, and White/Caucasian employees showed higher completion rates of advance directives. These disparities suggest the need for targeted education and outreach. Understanding these demographic influences can help tailor educational programs and resources to address specific barriers and promote broader adoption of advance directives across diverse groups within the healthcare workforce.

How can the gap in advance directive completion among healthcare providers be addressed?

The gap can be addressed by increasing awareness, providing education, and removing barriers to completion. This includes promoting the importance of advance directives, offering educational sessions on how to complete the documents, and addressing the emotional and practical challenges that healthcare providers face. By encouraging providers to lead by example, the healthcare community can set a precedent for patients and the wider community, ensuring that end-of-life wishes are respected and honored.