Does End-of-Life Planning Help Partners Become Better Surrogates?

PURPOSE OF THE STUDY This study investigates the role of surrogates' involvement in their partners' end-of-life care planning, focusing on the relationship between the extent and type of end-of-life planning in which surrogates have been involved and the accuracy of their substituted judgments. DESIGN AND METHODS The data come from an internet survey collected by Knowledge Networks and the National Center for Family and Marriage Research. The national sample is comprised of 1,075 opposite-sex American couples aged 18-64. A series of multilevel negative binomial regression analyses were conducted. RESULTS Surrogates' involvement in multiple types of planning helped them to make accurate substituted judgments, whereas surrogates' involvement in informal discussions helped them to make accurate estimations primarily when they wanted limited care for themselves. IMPLICATIONS This study highlights the importance of engaging in both advance directives and informal discussion. The findings also suggest that surrogates who want extensive care for themselves may need extra attention when practitioners assist them in making a substituted judgment.