Objectives 1) To examine the research evidence on the effectiveness of different methods for the delivery and completion of ADs; 2) To seek information regarding the local use of ADs in Alberta. [...] The completion rate of the DPAHC form was statistically significantly increased in the intervention group when compared to the completion rate in the control group after five months. [...] At a follow-up of 18 months, 70% of residents (49% competent residents and 78% of families of incompetent residents) in the intervention group had an AD, compared to 57% of the control home residents (the baseline AD completion rates, the percentages of competent and incompetent residents in the control group who completed ADs, and the statistical significance of the difference between the two gro [...] Eighty-nine percent of the completed directives in the intervention group were LMD, while 71% of the completed directives in the control group were DNR. [...] The authors offered the following observations to explain the lack of significant differences between the two groups: 1) overall, baseline comprehension of AD concepts among the residents was poor; 2) advanced age and lower educational levels were negatively associated with the level of understanding of CPR and living wills; or 3) the vocabulary, style, or pace of the information presented in the.