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MOST NEW JERSEYANS HAVE CONSIDERED BUT NOT PLANNED FOR END-OF-LIFE WISHES
One in 10 have talked to a doctor despite provider reimbursement
New Brunswick, N.J. (April 16, 2019) – In advance of National Health Care Decisions Day on April 16, a new poll shows that six in 10 New Jerseyans (61 percent) have given a great deal or at least some thought to their wishes for medical care towards the end of their life.
But only 47 percent have actually talked to someone about their wishes, 42 percent have designated someone to make decisions about their care if they are unable, and just 30 percent have a written document detailing their wishes.
These results come from the latest poll in the New Jersey Health Matters series by the New Jersey Health Care Quality Institute in partnership with the Eagleton Center for Public Interest Polling at Rutgers University-New Brunswick.
Among those who have had a conversation, just 24 percent have actually talked to a doctor or other healthcare provider even though Medicare and Medicaid reimburse providers for having end-of-life care consultations with patients.
Almost all New Jerseyans have talked about their end of life wishes with a loved one (97 percent) – whether a spouse, parent, child or someone else. About four in ten (39 percent) say they have talked to a lawyer or financial planner, while 7 percent have talked with a spiritual leader.
The vast majority of those who have prepared a written document have shared a copy with a family member or loved one (84 percent); a similar number has shared it with their designated health care proxy (86 percent). Half have shared this type of document with a lawyer or financial planner (51 percent), and a quarter have done so with a doctor or healthcare provider (24 percent).
“People are thinking about their end-of-life care wishes, but there’s a real gap when it comes to discussing them and writing them down,” said Ashley Koning, assistant research professor and director of the Eagleton Center for Public Interest Polling. “The gap is wider for some groups more than others, influenced by key factors like age, gender and race.”
“We know the best way to make sure your end-of-life wishes are respected and honored is to discuss and document them. And that’s why we created Conversation of Your Life (COYL),” said Linda Schwimmer, president and CEO of the New Jersey Health Care Quality Institute. “We therefore need physicians, nurses and other health care providers to encourage patients to talk about — and then document — their wishes. And if health care providers don’t bring the topic up, then patients should.”
Results are from a statewide poll of 1,203 adults contacted between March 7 and 22, 2019. Questions reported in this release were asked of a sub-sample, resulting in 622 New Jersey adults, 314 of which were contacted by live callers on both landlines and cell phones and 308 through an online probability-based panel. The combined sample has a margin of error of +/-5.0 percentage points Interviews were done in English and, when requested, Spanish. Find the full press release, including the poll questions and tables at http://eagletonpoll.rutgers.edu/rutgers-eagleton-NJHCQI-end-of-life-care-April-2019 or click here.
Preparation comes with age
As expected, age plays a significant role in behaviors related to end-of-life care. Seven in 10 senior citizens have given a great deal (30 percent) or at least some (41 percent) thought to their own medical wishes toward the end of their life. A similar number of seniors have also had a conversation with someone about their wishes (67 percent). Almost all (94 percent) have had this conversation with a loved one, about four in 10 with a lawyer or financial planner (44 percent), about three in 10 with a doctor or other healthcare provider (27 percent), and just a few with a religious leader (seven percent).
Seniors are also the most likely to have designated someone to be their healthcare proxy (67 percent) and to have a written document (61 percent) – such as a living will, 5 Wishes or practitioner orders for life sustaining treatment – detailing their wishes for care. Most have given a copy of this written document to a loved one (83 percent) or healthcare proxy (81 percent); almost a quarter (23 percent) have given it to a health care provider and about four in 10 (41 percent) have given it to a lawyer or financial planner.
More than six in 10 middle-aged residents have thought about their wishes toward the end of their life, but they are less prepared than their elders. Just around half have had a conversation with someone about it; among those who have, almost all have spoken to a loved one. Less than half have designated a healthcare proxy. Less than a third have a written document; among the small number who does, a loved one or their healthcare proxy is most likely to also have a copy.
End-of-life care is a distant thought for millennials: just 18 percent say they have thought a great deal and another 29 percent say they have thought some about their wishes. Twenty-three percent have taken the step of having a conversation about it with someone, 18 percent have designated a healthcare proxy, and only 7 percent have a written document detailing their wishes.
Gender, race affect preparation
Age may be the biggest driver of preparedness when it comes to end-of-life care, but other demographics play a part as well. There are large racial and ethnic disparities when it comes to end-of-life care. While New Jerseyans of all backgrounds have given at least some thought to their end of life care wishes, white residents are much more likely than non-white residents to have had a conversation about it with someone (53 percent to 39 percent), designated someone as their healthcare proxy (48 percent to 34 percent) and have a written document (37 percent to 20 percent).
“To address this gap, the Quality Institute will be expanding COYL programming into Hispanic communities in the coming months,” Schwimmer said.
Men are less likely than women to have had a conversation about their wishes (42 percent to 53 percent), but among those who have, a similar number of men and women have talked to a doctor, religious leader, or lawyer, while almost all have talked to a loved one. Men are almost as likely as women to have given their medical care wishes at least some thought as well as to designate a proxy and have a written document.
Marriage also plays a role. Those who are currently married are more likely than those who are not to have had a conversation with someone about their wishes (51 percent versus 44 percent), more likely to have designated someone as a proxy (50 percent versus 35 percent) and more likely to have a written document detailing their wishes (34 percent to 26 percent).
ABOUT CONVERSATION OF YOUR LIFE (COYL)
Conversation of Your Life (COYL) is a Mayors Wellness Campaign program that focuses on engaging communities in fruitful dialogue—the Conversation of Your Life—to let individuals’ family, friends and health care providers understand and respect their end-of-life care wishes through advance care planning. COYL is generously supported by The Horizon Foundation for New Jersey.
ABOUT THE NEW JERSEY HEALTH CARE QUALITY INSTITUTE
At the Quality Institute, we believe that collaboration is essential to improving our health care system. That’s why we bring providers, payers, patients and decision makers together to advance health care safety, quality and affordability. We’re the only independent, nonpartisan advocate working in New Jersey to promote accountability and transparency. We have more than 100 unique member organizations— all committed to improving health care for everyone in New Jersey. Learn more about us and check out our blog, SchwimmerScript at www.njhcqi.org. Follow us on Facebook, Twitter, and LinkedIn.
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ABOUT RUTGERS—NEW BRUNSWICK
Rutgers University–New Brunswick is where Rutgers, the State University of New Jersey, began more than 250 years ago. Ranked among the world’s top 60 universities, Rutgers’s flagship university is a leading public research institution and a member of the prestigious Association of American Universities. It is home to internationally acclaimed faculty and has 12 degree-granting schools and a Division I Athletics program. It is the Big Ten Conference’s most diverse university. Through its community of teachers, scholars, artists, scientists, and healers, Rutgers is equipped as never before to transform lives.
ABOUT THE EAGLETON CENTER FOR PUBLIC INTEREST POLLING (ECPIP)
Home of the Rutgers-Eagleton Poll, ECPIP was established in 1971 and is the oldest and one of the most respected university-based state survey research centers in the United States. ECPIP’s mission is to provide scientifically sound, non-partisan information about public opinion. To read more about ECPIP and view all of our press releases and published research, please visit our website: eagletonpoll.rutgers.edu. You can also visit our extensive data archive, Facebook, and Twitter.
ABOUT THE EAGLETON INSTITUTE OF POLITICS
The Eagleton Center for Public Interest Polling is a unit of the Eagleton Institute of Politics at Rutgers University-New Brunswick. The Eagleton Institute explores state and national politics through research, education, and public service, linking the study of politics with its day-to-day practice. The Institute focuses attention on how the American political system works, how it changes, and how it might work better. To learn more about Eagleton programs and expertise, visit eagleton.rutgers.edu.
Click here for the full press release including the poll questions and tables.