Communication with Family Increases Likelihood of Having a Living Will (TH370D)

Abstract

•Articulate national rates of advance care planning in contrast to rates described in this study population and state predictors of having a living will for both healthy and seriously ill populations.•Competent in referencing the importance of communication about death and dying in healthy and seriously ill populations during clinical practice. Advance care planning is an important mechanism through which individuals can communicate end-of-life preferences. These preferences are important to families in making end-of-life decisions for patients. Little research has been conducted on why individuals participate in advance care planning and how they communicate preferences to family. The purpose of this study was to determine whether previous experiences with communication about death and dying are positively associated with having a living will (LW). A cross-sectional survey was distributed to a random sample of members of the American Association of Retired Persons (ages > 50 years) in Massachusetts. The survey included questions about attitudes toward family communication about death and dying. Of 3,000 members approached, 1,447 (48%) completed the survey. Chi square and logistic regression analyses were performed to examine communication predictors of having a LW. Comfort talking about death [χ2 (1, n = 1,447) = 19.7, p< .001, and being likely to speak freely to family about death and dying [χ2 (1, 1,447) = 15.9, p< .001, were significant predictors of having a LW. In multivariate analyses, sex, older age, comfort with communication, and speaking freely to family about death and dying demonstrated a significant relationship with having a LW. Family communication about death and dying is associated with completion of a LW. Future interventions to promote family communication in routine clinical care as well as in those with serious illness are important and can ensure that patients' end-of-life preferences are known.