Meier Clément, Wieczorek Maud, Borrat-Besson Carmen, Jox Ralf J, Maurer Jürgen
Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland.
Swiss Centre of Expertise in the Social Sciences (FORS), Lausanne, Switzerland.
Innov Aging. 2025 Apr 24;9(6):igaf038. doi: 10.1093/geroni/igaf038. eCollection 2025.
Despite the importance of surrogate decision-making by partners at the end of life, there is only limited research on older adults' knowledge of their partners' end-of-life preferences. Hence, this study investigates older adults' perceived and actual knowledge of their partners' preferences for end-of-life care and medical treatments.
We analyzed data from 667 respondents aged 50+ from Wave 8 (2019/2020) of the Survey on Health, Ageing, and Retirement in Europe in Switzerland. We assessed respondents' actual knowledge by comparing their perceptions of their partners' preferences for end-of-life care and medical treatments with the partners' self-reported preferences. Additionally, respondents were asked to rate their perceived knowledge of their partners' wishes. Associations were assessed using multivariable regression models, adjusting for social, health, and regional characteristics.
Respondents' actual knowledge of their partners' preferences varied, with the share of correct answers ranging from 35% to 81% depending on the preferences. More than 80% of respondents felt that they knew their partners' end-of-life and medical treatment preferences "rather" or "very" well, and those respondents were more likely to identify their partners' preferences accurately.
Improved communication between partners regarding their end-of-life preferences could significantly enhance surrogate end-of-life decision-making. However, since older adults' perceived knowledge of their partners' preferences seems overly optimistic, they may see little need to initiate such conversations by themselves, emphasizing the need for external educational interventions such as role-plays or case study discussions through, say, the community, or healthcare system to encourage such conversations.
尽管伴侣在临终时进行替代决策很重要，但关于老年人对其伴侣临终偏好的了解的研究却很有限。因此，本研究调查老年人对其伴侣临终护理和医疗治疗偏好的感知知识和实际知识。
我们分析了来自瑞士的欧洲健康、老龄化与退休调查第8波（2019/2020年）的667名50岁及以上受访者的数据。我们通过将受访者对其伴侣临终护理和医疗治疗偏好的看法与其伴侣自我报告的偏好进行比较，来评估受访者的实际知识。此外，还要求受访者对他们对伴侣愿望的感知知识进行评分。使用多变量回归模型评估关联，并对社会、健康和地区特征进行调整。
受访者对其伴侣偏好的实际了解各不相同，正确答案的比例根据偏好从35%到81%不等。超过80%的受访者认为他们“相当”或“非常”了解伴侣的临终和医疗治疗偏好，而这些受访者更有可能准确识别伴侣的偏好。
改善伴侣之间关于临终偏好的沟通可以显著提高临终替代决策。然而，由于老年人对伴侣偏好的感知知识似乎过于乐观，他们可能觉得自己没有必要发起这样的对话，这凸显了通过社区或医疗保健系统等外部教育干预措施（如角色扮演或案例研究讨论）来鼓励此类对话的必要性。
