Dialysis patients' preferences for family-based advance care planning

Background: Most patients do not participate in advance care planning with physicians. Objective: To examine patients' preferences for involving their physicians and families in advance care planning. Design: Pace-to-face interviews with randomly selected patients. Setting: Community-based dialysis units in one rural and one urban region. Participants: 400 hemodialysis patients. Measurements: Questions about whom patients involve in advance care plannin g, whom patients would like to include in this planning, and patients' reac tions to state legislation on surrogate decision makers in End-of-life care . Results: Patients more frequently discussed preferences for end-of-life car e with family members than with physicians (50% compared with 6%; P < 0.001 ). More patients wanted to include family members in future discussions of advance care planning than wanted to include physicians (91% compared with 36%; P < 0.001). Patients were most comfortable with legislation that grant ed their family end-of-life decision-making authority in the event of their own incapacity (P < 0.001). Conclusion: Most patients want to include their families more than their ph ysicians in advance care planning.