Importance: @entity1442 ( @entity1442 ) may prevent end-of-life (EOL) care that is nonbeneficial and discordant with @entity1 wishes. Despite long-standing recognition of the merits of @entity1442 in oncology, it is unclear whether participation in @entity1442 by @entity1 with @entity5 has increased over time. Objectives: To characterize trends in durable power of attorney (DPOA) assignment, living will creation, and participation in discussions of EOL care preferences and to explore associations between @entity1442 subtypes and EOL treatment intensity as reflected in EOL care decisions and terminal hospitalizations. Design, Setting, and @entity1 : We analyzed prospectively collected survey data from 1985 next-of-kin surrogates of @entity283 ( @entity283 ) @entity1 with @entity5 who died between 2000 and 2012, including data from in-depth "exit" interviews conducted with the surrogates after the @entity1 's @entity204 . The @entity283 is a nationally representative, biennial, longitudinal panel study of US residents older than 50 years. Trends in @entity1442 subtypes were tested, and multivariable logistic regression models examined for associations between @entity1442 subtypes and measures of treatment intensity. Main Outcomes and Measures: Trends in the surrogate-reported frequency of DPOA assignment, living will creation, and participation in discussions of EOL care preferences; associations between @entity1442 subtypes and both surrogate-reported EOL care decisions and terminal hospitalizations. Results: From 2000 to 2012, there was an increase in DPOA assignment (52% to 74%, P   =   .03), without significant change in use of living wills (49% to 40%, P   =   .63) or EOL discussions (68% to 60%, P   =   .62). Surrogate reports that @entity1 received "all care possible" at EOL increased during the period (7% to 58%, P   =   .004), and rates of terminal hospitalizations were unchanged (29% to 27%, P   =   .70). Limiting or withholding treatment was associated with living wills (adjusted odds ratio [AOR], 2.51; 95% CI, 1.53-4.11; P   <   .001) and EOL discussions (AOR, 1.93; 95% CI, 1.53-3.14; P   =   .002) but not with DPOA assignment. Conclusions and Relevance: Use of DPOA increased significantly between 2000 and 2012 but was not associated with EOL care decisions. Importantly, there was no growth in key @entity1442 domains such as discussions of care preferences. Efforts that bolster communication of EOL care preferences and also incorporate surrogate decision makers are critically needed to ensure receipt of goal-concordant care.

Trends in Advance Care Planning in @entity1 With XXXX : Results From a National Longitudinal Survey.

@entity1 :: ('9606', 'Species') :: ['participants', 'patients', 'participant', 'patient', 'Participants'] @entity283 :: ('OMIM:603663', 'Disease') :: ['HRS', 'Health and Retirement Study'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity1442 :: ('MESH:D020178', 'Disease') :: ['ACP', 'Advance care planning'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity5 :: (MESH:D009369,Disease) :: ['Cancer']
