Older adults' preferences for independent or delegated end-of-life medical decision making.
OBJECTIVE
This study assesses the proportions of participants who prefer independent or delegated medical decision making at the end of life and examines the relationships of personal beliefs, affiliative beliefs, and end-of-life planning behaviors to decision-making preference.


METHODS
Data are drawn from the Wisconsin Longitudinal Study, a sample of nearly 4,500 healthy White Midwestern high school graduates in their mid-60s.


RESULTS
Four fifths of participants wanted to make decisions independently. Valuing independence, being less avoidant of thoughts of death, and valuing quality of life over length of life had strong associations with a preference for independent decision making. Those concerned about burdening a caregiver wanted to make independent decisions. Persons who both executed a living will and appointed a durable power of attorney for health care preferred independent decision making.


CONCLUSIONS
Older adults cite personal and affiliative beliefs, not lack of autonomy, as reasons for their choice to decide independently or delegate.
Boston College, Chestnut Hill, MA, USA. Sara.Moorman.1@bc.edu
Sara M
SM
Moorman
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000375:Aging / Q000502:physiology*; D001293:Attitude to Death; D016009:Chi-Square Distribution; D002755:Choice Behavior; D003142:Communication; D016001:Confidence Intervals; D003657:Decision Making; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016224:Living Wills / Q000523:psychology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D015999:Multivariate Analysis; D016017:Odds Ratio; D017060:Patient Satisfaction; D026684:Personal Autonomy; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology; D055815:Young Adult