Perceptions of Own and Spouse’s Survival: Do Life Span Projections Affect End-of-Life Health Care Planning?

• In Event: 473 - Section on Aging and the Life Course Paper Session. Health and the Life Course

Abstract

Advance care planning (ACP) is considered an essential step toward ensuring that one’s preferences for medical care at the end of life are heeded. ACP, which comprises a living will, durable power of attorney for health care (DPAHC) appointment, and discussions, are only weakly linked to one’s objective health conditions, however. We propose that ACP may be linked to one’s perceptions about one’s own and one’s spouse’s future life span. Drawing on socioemotional selectivity and illness representation theories, we expect that older adults who anticipate a lower likelihood of survival will be more likely to engage in ACP, as they view death as imminent and ACP as urgent. We use data from the Wisconsin Longitudinal Study (WLS), a sample of married white men and women who graduated Wisconsin high schools in 1957 and were in their early 60s at the time of interview (2003-04). We find stark gender differences in perceptions about one’s future life span, and these perceptions mirror epidemiologic data showing women’s life expectancy advantage. We find weak evidence of linkages between projected survival and ACP. For men only, the odds of having a living will decline as one’s projected survival likelihood increases, and the decline is steepest among those with the most expansive future time horizons. Men who expect to outlive and women who expect to be outlived by their spouses are less likely to name a DPAHC. We discuss the implications of our findings for health care practice, and highlight avenues for future exploration.

Authors

• Deborah Carr, State University of New Jersey-Rutgers

• Elizabeth Anne Luth, State University of New Jersey-Rutgers