Background Although legal and ethical aspects related to the care of people with dementia have been long neglected, current guidelines highlight its importance. Specifically, the advanced directives document (ADs) is a useful instrument in decision-making in non-competent patients. Despite the promotion of guidelines related to the use of ADs, it is claimed that adherence is not as optimal as desired. An analysis of the barriers to implementation is therefore needed.

Objectives To explore health professionals’ knowledge and attitudes towards the use of ADs in three different health settings and to evaluate their adherence to the established recommendations.

Methods A cross sectional, descriptive study by means of a self-administered questionnaire was conducted with over 2,000 professionals working in dementia care in the Basque Country. On the other hand, the relevant recommendations from the ADs in cases of dementia are summarised and it is discussed whether professionals comply with them.

Results Data is currently being analysed and results will be available for presentation at GIN.

Discussion Adherence to CPG is a long discussed issue. Bringing ethical issues into the debate makes it more complex, since not only the knowledge but the personal values are in place. That may explain why ethical and legal related recommendations and clinical practice differ considerably and why the use of ADs in the real practice remains a taboo.

Implications for Guideline Developers/Users Knowing the barriers to comply with ADs may help to put the mechanism in place to reduce the gap between theory and practice.