Abstract
Context
Advance Care Planning is a process of understanding and sharing preferences regarding
future medical care.
Objective
To explore individual and national stability of end-of-life treatment preferences
among a sample of older adults.
Methods
National Health and Aging Trends Study is a nationally representative sample of older
adults. In 2012, a random sample, and in 2018, the entire sample were queried on end-of-life
treatment preferences defined as acceptance or rejection of life prolonging treatment
(LPT) if they had a serious illness and were at the end of their life and in severe
pain or had severe disability. Using a cohort design, we explored individual trends
in preferences for LPT among those with responses in both waves (pain scenario: N = 606, disability scenario: N = 628) and, using a serial cross-sectional design, national trends in LPT among the
entire sample (1702 older adults in wave 2 and 4342 in wave 8).
Results
In the cohort study, individual preferences were stable over time (overall percent
agreement = 86% for disability and 76% for pain scenarios), particularly for older
adults who would reject LPT in wave 2 (overall agreement 92% for disability and 86%
for pain). In the serial cross-sectional study, national trends in preferences for
receipt of LPT were stable over time in the pain (27.4% vs. 27.0%, P = 0.80) and disability (15.8% vs. 15.7%, P = 0.99) scenarios.
Conclusions
We found that national trends in preferences for end-of-life treatment did not substantially
change over time and may be stable within individual older adults.
Key Words
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Article info
Publication history
Published online: June 25, 2022
Accepted:
June 20,
2022
Footnotes
Paper presentation: None.
Identification
Copyright
© 2022 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
