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.