Changing Perceptions on End-of-Life Issues

According to a recent Pew survey, the share of the total U.S. population that is age 65 and older has more than tripled over the last century, from roughly 4% in 1900 to 14% in 2012.  Recently, the Pew Research Center interviewed a subset of the aging population (nearly 2,000 adults), providing a glimpse into changing perceptions on end-of-life issues in the U.S.

The findings were as follows:

End-of-life treatment decisions

  • 31 % believe health professionals should do everything possible to save a patient’s life. This group has increased 9 % since 2005 and 16 % since 1990;
  • 57 % would ask to stop treatment if they were in great pain with no hope of improvement;
  • 52 % would say “enough” if they had an incurable disease and were totally dependent on others;
  • 35 % would instruct their doctors to do everything to keep them alive even if they were in pain and weren’t going to improve.

End-of-life planning

  • Only four-in-ten U.S. adults (37%) say they have given a great deal of thought to their wishes for medical treatment at the end of their lives;
  • 35% have given some thought to these issues;
  • 27% say they have not given very much thought or have given no thought at all to how they would like doctors and other medical professionals to handle their medical treatment at the end of their lives;
  • Even among Americans ages 75 and older, one-in-four say they have not given very much or any thought to their end-of-life wishes;
  • Further, one-in-five Americans ages 75 and older (22%) say they have neither written down nor talked with someone about their wishes for medical treatment at the end of their lives;
  • Three-in-ten of those over 75 who describe their health as fair or poor have neither written down nor talked about their wishes with anyone.


Dr. VJ Periyakoil, director of the Palliative Care Education and Training Program at Stanford University School of Medicine, interpreted the results and offers suggestions for end-of-life conversations. She makes an excellent point that your position on end-of-life decisions may be a lot different when you find yourself as the patient, rather than in a non-crisis situation. According to Periyakoil, treatment decisions are often influenced by your loved ones and by your cultural and religious beliefs. Therefore, it is important that the family, not just the patient, be part of the conversation from early on and they should be treated as a caregiving unit. Another important point Periyakoil makes is that end-of-life conversations shouldn’t just be focused on end-of-life, but more on the quality of life. For more details on end-of-life conversations, please read our recent newsletter article.

Talking about end of life issues is an emotional and difficult task for most of us, and it is an important first step to making sure your wishes are clear. Once you have taken the step of speaking with your loved ones about your wishes, it is important to sign Incapacity Planning documents, including an Advance Medical Directive and General Power of Attorney, to make your wishes legally enforceable. If you and your loved ones have not done Incapacity Planning , Estate Planning, or Long-Term Care Planning (or had your Planning documents reviewed in the past several years), now is a good time to plan ahead and be prepared. Learn more at The Fairfax and Fredericksburg Elder Law Firm of Evan H. Farr, P.C. website, or call us at our Virginia Elder Law Fairfax office at 703-691-1888 or at our Virginia Elder Law Fredericksburg office at 540-479-1435 to make an appointment for a consultation.

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About Evan H Farr, CELA, CAP

Evan H. Farr is a 4-time Best-Selling author in the field of Elder Law and Estate Planning. In addition to being one of approximately 500 Certified Elder Law Attorneys in the Country, Evan is one of approximately 100 members of the Council of Advanced Practitioners of the National Academy of Elder Law Attorneys and is a Charter Member of the Academy of Special Needs Planners.