title: Beyond polarization, public preferences suggest policy opportunities to address aging, dying, and family caregiving.
abstract: Despite well-documented deficiencies and widespread suffering experienced by millions of elderly or ill Americans and their families, politicians rarely address end-of-life issues. Citizen Forums in New Hampshire surveyed 463 people regarding aging, serious illness, and caregiving. More than 80% indicated it was very or extremely important to have their dignity respected, preferences honored, pain controlled, and to not leave family with debt. Less than half strongly endorsed being kept alive as long as possible, prayed with or for, or having assisted-suicide available. Over 80% strongly endorsed palliative care requirements clinical licensure and reimbursement, expansion of family caregiver leave, respite care, and bereavement support. By avoiding actions which elicit strong divergence of opinion and focusing on actions on which consensus exists, public officials and candidates can respond to problems and improve care and experience for frail elders, dying Americans, and their families.
authors.affiliation: Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA. IByock@aol.com
authors.forename: Ira R
authors.initials: IR
authors.lastname: Byock
authors.forename: Yvonne J
authors.initials: YJ
authors.lastname: Corbeil
authors.forename: Martha E
authors.initials: ME
authors.lastname: Goodrich
mesh_terms: D000328:Adult; D000368:Aged; D001293:Attitude to Death; D017028:Caregivers; D003258:Consumer Behavior / Q000706:statistics & numerical data*; D003695:Delivery of Health Care / Q000458:organization & administration; D004517:Education, Professional; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D017051:Hospice Care; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009513:New Hampshire; D010166:Palliative Care; D019035:Rural Health Services / Q000458:organization & administration; D012944:Social Support; D012945:Social Values; D013727:Terminal Care / Q000458:organization & administration*; D055815:Young Adult