The Role of Relationship Biography in Advance Care Planning Among Older Adults

• In Event: 30860 - Section on Aging and the Life Course Roundtables
  In Refereed Roundtable (90 minute): Table 6. End-of-Life Planning, Death, and Bereavement

Abstract

Advance care planning (ACP) is essential for ensuring a good death, characterized by minimal distress and alignment with the patient's and family's wishes. Despite the critical nature of ACP, significant gaps in engagement remain among older adults in the United States, with less than half having completed necessary legal documents or discussed their medical preferences in depth. This study explores how dynamic relationship histories throughout the life course, rather than static marital status, influence ACP behaviors such as the completion of living wills, the designation of durable powers of attorney for healthcare, and participation in end-of-life discussions. Employing a gendered life course perspective, we analyze data from the Health and Retirement Study to examine the cumulative effects of relationship trajectories on ACP engagement and how these effects vary by gender. Our findings suggest that relationship history is a significant, though previously underexamined, social determinant of ACP, offering new insights into the life course factors that shape end-of-life planning.

Authors

• Zhe Zhang, Vanderbilt University

• Lucie Kalousova, Vanderbilt University