Journal
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
Volume 64, Issue 10, Pages 1962-1967Publisher
WILEY
DOI: 10.1111/jgs.14285
Keywords
end-of-life care preparation; Medicare; discussion
Categories
Funding
- National Cancer Institute [K07 CA187071]
- National Institute on Aging [K01AG047923]
- K23 Beeson award from the National Institute on Aging [1K23AG040774]
- American Federation for Aging Research
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ObjectivesTo determine the prevalence of end-of-life (EOL) conversations with older adults. DesignNational Health and Aging Trends Study (NHATS), a prospective, longitudinal survey of Medicare beneficiaries. SettingNationally representative. ParticipantsA sample drawn from Wave 2 of the NHATS. MeasurementsThe main outcome was the report of an EOL planning discussion, based upon the participant's response to the question Have you talked to anyone about the types of medical treatment you would want or not want if you became seriously ill in the future? ResultsSixty-one percent of the sample (n = 1,993 individuals, weighted n = 11,123,910) responded that they had discussed EOL treatment preferences with someone. In multivariate regression, factors associated with reporting an EOL discussion included being younger (adjusted odds ratio (AOR) = 1.70, 95% confidence interval (CI) = 1.17-2.47), having more education (high school degree: AOR = 1.45, 95% CI = 1.02-2.07; some college: AOR = 2.03, 95% CI = 1.40-2.95), and having multiple chronic conditions (AOR = 1.25, 95% CI = 1.01-1.55). Black race was associated with lower odds of reporting a discussion (AOR = 0.46, 95% CI = 0.33-0.65). ConclusionForty percent of a nationally representative sample of Medicare beneficiaries had not discussed their preferences regarding EOL medical treatment. Promoting these conversations in clinical and nonclinical settings will be important to ensure that health care is delivered to individuals in a person-centered manner.
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