title: "I don't want to die like that ...": the impact of significant others' death quality on advance care planning.
abstract: OBJECTIVE
  I examine whether 5 aspects of a significant other's death quality (pain, decision-making capacity, location, problems with end-of life care, and preparation) affect whether one does advance care planning (ACP). I also identify specific aspects of others' deaths that respondents say triggered their own planning.
  
  
  METHODS
  Data are from the New Jersey End of Life study, a survey of 305 adults age 55+ seeking care at 2 major New Jersey medical centers. I estimate multivariate logistic regression models for a subsample of 253 participants who recently lost a loved one and provide descriptive findings from an open-ended question regarding the motivation for one's ACP.
  
  
  RESULTS
  Multivariate analyses revealed "positive" role model effects; persons who witnessed significant others' deaths that occurred at home, were free of problems associated with end-of-life care, and where advance directives were used are more likely to make end-of-life preparations. Open-ended data showed that 19% cited others' deaths as the main trigger for their own planning, with most citing negative factors (pain, connection to machines, coma) that they hoped to avoid.
  
  
  CONCLUSIONS
  Practitioners should encourage patients to use conversations about others' deaths as springboards for discussions about one's own end-of-life care, and to engage in ACP together with family. Implications for health care reform are highlighted.
authors.affiliation: Department of Sociology, Rutgers University, 116 Paterson St. New Brunswick, NJ 08901, USA. carrds@rci.rutgers.edu
authors.forename: Deborah
authors.initials: D
authors.lastname: Carr
mesh_terms: D032722:Advance Care Planning; D016223:Advance Directives / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D003643:Death; D003657:Decision Making; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009042:Motivation; D015999:Multivariate Analysis; D009515:New Jersey; D011788:Quality of Life; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000523:psychology*