Background There are many types of advance directives. Most common being the Durable Power of Attorney for Healthcare (DPAHC). In this type of advance directive the patient chooses a healthcare representative, who may be a friend, spouse, or family member who will be responsible for healthcare decisions and will act in the patient’s best interest once the patient is incapacitated. In California the DPAHC was replaced by the Advance Health Care Directives AHCD in July 2000 based on the Natural Death Act of 1972. The problem is the lack of education about AHCP. End-of-life decisions are difficult to discuss for patients, family, and healthcare providers (HCP).

Aim Purpose was to determine the effectiveness of AHCP education among independent community-dwelling older adults >60 and to promote communication about end-of-life preferences among participants, family-members/HCP.

Methods Pre-test assessed knowledge level using face-to-face surveys including demographic data with 20 participants at retirement self-contained apartments. Post-test survey was conducted after an educational presentation. Descriptive/inferential statistical analysis was used.

Results Statistically significant overall improvement p = 0.001 was achieved. Many older adults did not like discussing end-of-life issues due to lack of knowledge of health, fear or guilt. Three most important issues were: not to be a burden to families; being off machines that extend life support; being pain free.

Discussion Open communication among clinicians/family/patients will prepare patients from transition-contemplative-receptive stage. Increased knowledge will improve relationships between patients/families.

Conclusion AHCP increases knowledge about death/dying, reduces anxiety by recognising death as normal aspect of life, increases autonomy for decision-making.