Prior studies show that Advanced Care Planning (ACP) is associated with better transitions to palliative care, more hospice use, and other characteristics of “good death.” Less is known about the differences in use of ACP and location of death between people dying from different terminal illnesses. Factors associated with provision of written instructions about care at the end of life (e.g. living will) and location of death were examined between decedents whose main cause of death were cancer or cardiovascular diseases.

The Harmonized End of Life data sets, a linked collection of variables derived from the Health and Retirement Study (HRS) Exit interviews between 1992 and 2014 were obtained. Cancer decedents (N=2,969) and decedents of cardiovascular diseases (N=4,558) were identified. Gender, age at death, marital status at death, race, level of education, and functional status before death were included to predict the likelihood of having a living will in place. Multinomial logistic regressions were used to evaluate factors associated with locations of death.

Decedents who died of cancer were more likely to have a living will in place, compared to those who died of cardiovascular diseases (OR = 1.5, p<.001) and cancer decedents were more likely to die at a hospice (versus died at hospitals, OR=3.4, p<.001).

Dying has become a prolonged process occurred, mostly, to older adults suffering from chronic diseases. The differences in advanced care planning and locations of death could reflect the different declining trajectories in health among patients dying of various terminal illnesses