Conversations about end-of-life care are difficult. But even though most people now take some steps to communicate their wishes, many may still receive more intensive care than they would have wished, a study published in July found.
The findings, published online in JAMA Oncology, came from an analysis of the Health and Retirement Study, a national survey of U.S. residents older than age 50. Researchers looked through the responses from the next of kin, usually a spouse or child, of 1,985 participants with cancer who died between 2000 and 2012.
The patients' family members responded to questions about how frequently patients had signed durable power of attorney documents or living wills or participated in end-of-life care conversations. Researchers then examined the association between those advance-care-planning activities and the treatment patients received at the end of life.
Over the study period, the use of durable power of attorney assignment, sometimes called a health care proxy, grew from 52 percent to 74 percent among participants. Small declines were reported in other planning activities — from 49 percent to 40 percent for living wills and 68 percent to 60 percent for end-of-life discussions. But those changes weren't statistically significant because the levels varied throughout the study period, says Dr. Amol Narang, a radiation oncologist at Johns Hopkins School of Medicine and the lead author of the study.