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Living will use in U.S. up sharply since start of pandemic, study shows

A website that provides living will services saw more traffic in the first four months of 2020 than in all of 2019, according to a study. Photo by Free-Photos/Pixabay
A website that provides living will services saw more traffic in the first four months of 2020 than in all of 2019, according to a study. Photo by Free-Photos/Pixabay

July 20 (UPI) -- The COVID-19 pandemic in the United States has led to a five-fold increase in the number of Americans who look to complete advance healthcare directives online, according to a study published Monday by JAMA Network Open.

The findings are based on analysis of traffic on the website OurCareWishes.org, which offers users free guidance on creating a "living will." A living will is a legal document that outlines healthcare preferences in the event of an emergency.

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In a typical month, from January 2019 through February of this year, the site attracted between 22 to 30 new users, they said.

However, in March and April, as the coronavirus began to take hold in the United States, the site saw up to 207 new users monthly, the analysis revealed.

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"The reality of COVID-19 is an unprecedented number of deaths, striking rates of critical illness and, as we are continuing to learn, persistent symptoms and morbidity in survivors," study co-author Dr. Catherine Auriemma, a pulmonary and critical care medicine fellow at the Hospital of the University of Pennsylvania, told UPI.

"Thoughtful consideration of these facts would strike discomfort and, perhaps, reflection on one's own mortality, in just about anyone -- add to that strict visitation rights, and it's very understandable that people would want to get their wishes in writing," Auriemma said.

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As of Monday, nearly 3.8 million Americans have been diagnosed with COVID-19 and nearly 141,000 have died from the virus, according to figures from Johns Hopkins University.

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An advance directive or living will is a legal document in which people specify what medical treatments -- if any -- should be used if they are incapacitated or no longer able to make decisions for themselves because of illness, Auriemma and her colleagues said.

A 2017 analysis found that fewer than one-third of American adults had completed one of these forms, they said.

OurCareWishes.org had 482 new users in February, March and April of this year, compared to 424 from January 2019 to January 2020, the researchers said.

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Completion rates increased for five of the site's nine optional modules after the COVID-19 outbreak started in the United States, they said.

Thirty-eight percent of site users completed the "important end-of-life priorities" section during the pandemic months, compared to 24% in 2019, according to the researchers.

In addition, 23% set out their "wishes for [their] final days" during the pandemic months, versus 13% in 2019, they said.

"Our study shows that if you provide patients a free, easily accessible platform through which they can independently complete an advance directive they will do so," Auriemma said.

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"I don't think of a global pandemic providing that motivation as being the positive outcome, but rather that we've finally established a way for patients to access these resources with fewer barriers."

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