End-of-life treatment preferences have stagnated

Understanding and expressing choices for future medical treatment is the process of advance care planning. For one study, researchers sought to investigate the consistency of end-of-life treatment preferences at the personal and societal level among a population of older adults.

A nationally representative sample of seniors is used in the National Health and Aging Trends Study. Asked about their preferences for end-of-life care in 2012, a random sample, and in 2018, the entire sample, respondents indicated whether they would accept or refuse life-prolonging treatment (LPT ) if they had a serious illness, were nearing the end of their life, were in excruciating pain, or were severely disabled. They investigated national trends in LPT across the entire sample using serial cross-sectional methodology, as well as individual trends in preferences for LPT among individuals who responded to both waves (scenario of pain: N=606, disability scenario: N=628) using a cohort approach (1,702 elderly in wave 2 and 4,342 in wave 8).

Specifically, among older adults who would reject LPT in wave 2 (overall agreement 92% for disability and 86% for pain), individual preferences remained constant over time in the cohort study (percentage of overall agreement = 86% for disability and 76% for pain scenarios). National trends in preferences for receiving LPT are stable over time in pain situations (27.4% versus 27.0%, P=0.80) and disability (15.8% vs. 15.7%, P=0.99) in serial cross-sectional analysis.

Reference: jpsmjournal.com/article/S0885-3924(22)00787-4/fulltext