Three essays on end-of-life planning

Date

2020-05

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Abstract

End-of-life (EOL) planning allows individuals to express their wishes regarding their end-of-life health care. This can include preferences regarding the use of life-sustaining technology (living will) and appointing another to make health care decisions for them when they cannot (durable power of attorney for healthcare). Despite the benefits of planning strategies, completion rates remain low. This dissertation focuses on decision-making in end-of-life health and financial planning. First essay focuses on the association of financial planning time horizon with both EOL financial and EOL health planning documents. Using multinomial logistic regressions, findings show that EOL financial planning and EOL health planning are associated with one another, and the longer the financial planning time horizon, the higher the probability of having both plan choices. The second essay shows that different measures of religiosity have significant and opposite associations with the use of advance directives. Having a higher stated religious commitment is negatively associated with advance directives. But, having more frequent attendance at religious services is positively associated with advance directives. This suggests that religiosity is not a simple, unitary characteristic but has both personal and social elements that can influence choices in significant and opposing ways. The third essay tests the extent to which social norms and or the reference to family benefit impact the completion of the living will document. Overall results weakly support the use of social norms alone and more strongly supports the combination of social norms and family benefit together. However, although references to family benefit alone significantly increased interest in completing documents among men, they insignificantly decreased interest among women.

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Advance directives, End-of-life planning

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