Perceptions and knowledge of end-of-life medical situations among older adults in Switzerland.
C. Meier1, S. Vilpert1, J. Maurer1, G. D. Borasio1, R. J. Jox1 (1Lausanne)
Perceptions and knowledge regarding health care situations at the end of life can influence individuals' advance care planning, such as the completion and content of advance directives. Yet, little is known about these perceptions and their accuracy among older adults in Switzerland.
We aimed to assess the perceptions of medical end-of-life situations and corresponding sociodemographic data in a nationally representative sample of adults aged 58 years and older in Switzerland. We also aimed to gauge the degree of accuracy of these perceptions to identify potential misrepresentations and knowledge gaps concerning medical aspects of end-of-life care.
Our data come from a paper-and-pencil self-administered questionnaire survey on end-of-life issues incorporated into wave 8 (2019/2020) of the Swiss part of the Survey of Health, Ageing, and Retirement in Europe (SHARE). Respondents evaluated the likelihood of 11 end-of-life situations on a four-point scale (1= very unlikely (0-25%), 2= rather unlikely (26-50%), 3= rather likely (51-75%), 4= very likely (76-100%)). The assessments include, among others, the probability to die at a certain place (nursing home, hospital, home), to be diagnosed with dementia in a given age group, to survive a cardiopulmonary resuscitation at a certain age, and to benefit from a fourth-line chemotherapy.
Preliminary results indicate considerable heterogeneity in older adults' perceptions of end-of-life medical situations, as well as high levels of inaccuracy. Inaccurate views are more frequent among men than women and individuals with relatively low education levels. Adults aged 75 years and older and those from the German-speaking part of Switzerland appear to have more accurate perceptions of healthcare-related end-of-life realities in Switzerland.
Our findings suggest that interindividual differences in what can be called end-of-life literacy may be an important factor explaining variations in advance care planning behavior among older adults in Switzerland. In addition, the generally low degree of end-of-life literacy suggests considerable scope for communication interventions to improve individuals' perceptions of healthcare-related end-of-life issues and enable them to prepare and manage more effectively their own end of life as well as that of their loved ones.