@article{10d00f52ec2e4fcc8b978df7dde3e611,
title = "Older adults{\textquoteright} preferences for discussing long-term life expectancy: Results from a national survey",
abstract = "PURPOSE Clinical practice guidelines recommend incorporating long-term life expectancy to inform a number of decisions in primary care. We aimed to examine older adults{\textquoteright} preferences for discussing life expectancy in a national sample. METHODS We invited 1,272 older adults (aged 65 or older) from a national, probability-based online panel to participate in 2016. We presented a hypothetical patient with limited life expectancy who was not imminently dying. We asked participants if they were that patient, whether they would like to talk with the doctor about how long they may live, whether it was acceptable for the doctor to offer this discussion, whether they want the doctor to discuss life expectancy with family or friends, and when it should be discussed. RESULTS The 878 participants (69.0% participation rate) had a mean age of 73.4 years. The majority, 59.4%, did not want to discuss how long they might live in the presented scenario. Within this group, 59.9% also did not think that the doctor should offer the discussion, and 87.7% also did not want the doctor to discuss life expectancy with family or friends. Fully 55.8% wanted to discuss life expectancy only if it were less than 2 years. Factors positively associated with wanting to have the discussion included higher educational level, believing that doctors can accurately predict life expectancy, and past experience with either a life-threatening illness or having discussed life expectancy of a loved one. Reporting that religion is important was negatively associated. CONCLUSIONS The majority of older adults did not wish to discuss life expectancy when we depicted a hypothetical patient with limited life expectancy. Many also did not want to be offered discussion, raising a dilemma for how clinicians may identify patients{\textquoteright} preferences regarding this sensitive topic.",
keywords = "Communication, Decision making, Life expectancy, Older adults, Patient preference, Personalized medicine, Practice-based research, Primary care, Vulnerable populations",
author = "Schoenborn, {Nancy L.} and Janssen, {Ellen M.} and Cynthia Boyd and Bridges, {John F.P.} and Wolff, {Antonio C.} and Xue, {Qian Li} and Pollack, {Craig E.}",
note = "Funding Information: Research reported in this article was supported by the National Institute on Aging of the National Institutes of Health (NIH) under award number R03AG050912. In addition, Dr Schoenborn was supported by a T. Franklin Williams Scholarship Award with funding provided by Atlantic Philanthropies, Inc; the John A. Hartford Foundation; the Alliance for Academic Internal Medicine-Association of Specialty Professors; and the American Geriatrics Society; the Johns Hopkins KL2 Clinical Scholars program funded by KL2TR001077 from the National Center for Advancing Translational Sciences (NCATS), a component of the NIH, and NIH Roadmap for Medical Research; and a Cancer Control Career Development Award from the American Cancer Society (CCCDA-16-002-01). Dr Boyd was supported by 1K24AG056578 from the National Institute on Aging. Dr Xue was supported by P30AG021334 from the National Institute on Aging. Funding Information: Funding support: Research reported in this article was supported by the National Institute on Aging of the National Institutes of Health (NIH) under award number R03AG050912. In addition, Dr Schoenborn was supported by a T. Franklin Williams Scholarship Award with funding provided by Atlantic Philanthropies, Inc; the John A. Hartford Foundation; the Alliance for Academic Internal Medicine-Association of Specialty Professors; and the American Geriatrics Society; the Johns Hopkins KL2 Clinical Scholars program funded by KL2TR001077 from the National Center for Advancing Translational Sciences (NCATS), a component of the NIH, and NIH Roadmap for Medical Research; and a Cancer Control Career Development Award from the American Cancer Society (CCCDA-16-002-01). Dr Boyd was supported by 1K24AG056578 from the National Institute on Aging. Dr Xue was supported by P30AG021334 from the National Institute on Aging. Publisher Copyright: {\textcopyright} 2018, Annals of Family Medicine, Inc. All rights reserved.",
year = "2018",
doi = "10.1370/afm.2309",
language = "English (US)",
volume = "16",
pages = "530--537",
journal = "Annals of Family Medicine",
issn = "1544-1709",
publisher = "Annals of Family Medicine, Inc",
number = "6",
}