Understanding and expressing choices for future medical treatment is the process of advance care planning. For a study, researchers sought to investigate the consistency of end-of-life treatment preferences on a personal and a societal level among an older adult population.
A nationally representative sample of senior citizens is used in the National Health and Aging Trends Study. When 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 reject life-prolonging treatment (LPT) if they had a serious illness, were nearing the end of their lives, was in excruciating pain, or were severely disabled. They investigated national trends in LPT across the overall sample using a serial cross-sectional methodology, as well as individual trends in preferences for LPT among individuals who responded in both waves (pain scenario: N = 606, disability scenario: N = 628) using a cohort approach (1,702 older adults in wave 2 and 4,342 in wave 8).
Specifically, among older persons 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 (overall percent agreement = 86% for disability and 76% for pain scenarios). National trends in preferences for receiving LPT were steady over time in the situations of pain (27.4% vs. 27.0%, P=0.80) and disability (15.8% vs. 15.7%, P=0.99) in the serial cross-sectional analysis.