Do people think that ADRTs and LPAs are well understood?

Do people think that Advance Decisions and the role of Welfare Attorneys (LPAs) are well understood?

I'm asking, because a doctor contact of mine recently commented that sometimes a patient who is still mentally-capable will accept a visit to, or stay in, hospital to sort out a medical issue, while also having an ADRT which refuses hospital admission - and a relative will say '... but he's got an ADRT saying he doesn't want to go to hospital'. As I pointed out to my doctor contact:

'While I'm capacitous I can't lose argument with my own Advance Decision!'

Also, and some judges seem to not fully appreciate this, the ADRT is about what should happen AFTER you've lost capacity - while still capacitous, you can make decisions at the time. Voting isn't something an ADRT could cover, but suppose you could still vote if you were comatose. Your position might be 'while I can, I decide which party to vote for on an election-by-election basis, so I can vote for different parties if I decide to - but, if I become comatose, I always want my vote to go to Party A'.

My doctor contact also thinks that sometimes Welfare Attorneys don't seem to understand their role, to the point where he wonders if they read the LPA documentation or not.

So - how well do people think ADRTs and LPAs are understood?