Prospective end-of-life treatment decisions and perceived vulnerability: Future time left to live and memory self-efficacy

Abstract

Objective: Public policy and opinion support autonomous medical decision-making; however, research on perceptions related to future functioning that may influence health-related decisions is limited. Additional research is needed to understand individual perceptions for engaging in future life-sustaining treatment decisions.

Methods: Perceived time left to live and memory self-efficacy were assessed among 77 adults (M = 74.5 ± 7.18 years) indicating preferences for cardiopulmonary resuscitation, mechanical ventilation, and artificial feeding and fluids in hypothetical illness scenarios.

Results: Participants with a more expansive perspective of future time, less perceived change in memory, greater perceived memory capacity, and greater depressive symptomatology and Blacks/African Americans had greater overall desire for treatment.

Conclusion: Differences in perceived time left to live and memory beliefs affect treatment desires in ways that may not be recognized by families and/or physicians. Identifying perceptions associated with end-of-life treatment preferences may improve interventions that facilitate quality care through patient autonomy.

Keywords:

• decision-making
• end-of-life
• race/ethnicity
• life-sustaining treatment
• socioemotional selectivity theory

Acknowledgments

Portions of this article were presented at the 61st annual scientific meeting of the Gerontological Society of America, National Harbor, MD, November 2008. Funding from the McNair Scholars Program and the Center for Mental Health and Aging at The University of Alabama supported this research. We thank Jamie DeCoster, Ph.D. and Brent J. Small, Ph.D. for their statistical consultation.