October 9, 2017 Study: Most Americans avoid end-of-life planning A recent study conducted by researchers at the University of Pennsylvania found only one in three Americans makes any kind of end-of-life plan. Even among U.S. adults with chronic illnesses, rates of EoL planning remain low. The researchers reported only 29.3 percent of survey participants had completed a living will. That rates jumps to 38.2 percent for individuals with chronic illness. Why aren't Americans planning for end-of-life considerations? The last time EoL planning became part of a national discussion was during the implementation of the Affordable Care Act. At the time, the federal government wanted to reimburse physicians for counseling patients about their end-of-life options. Although the proposal was limited to discussions about living wills and advanced directives, politics got in the way of productive conversation. According to PBS, political opponents of the Affordable Care Act labeled these counseling sessions as "death panels," a term that confused and frightened many Americans. Now, three years later, physicians still face roadblocks when it comes to discussing EoL options with patients. No one likes to think about death, but it is a necessary conversation that not only affects the patients themselves, but the people they care for and love. Many Americans are hesitant to talk about end-of-life planning. Restarting the conversation EoL considerations go beyond living wills and estate planning. In many cases, patients have no plan in place for potential palliative care needs down the line. Perhaps even more troubling is the fact that when patients do have an advanced directive, physicians may not even know it exists. The Centers for Disease Control and Prevention reported that between 65 and 76 percent of physicians whose patients had an advanced directive were unaware of it. The absence of a living will could introduce complicated legal concerns and make it difficult for physicians to decide on the best treatment options for their patients. Therefore, it's important that primary care doctors talk to their patients about EoL planning. Dr. Jim deMaine, a medical professional with over 50 years of experience, wrote that he believes in the shared decision making between patient and physician. That means that doctors sit down with patients and discuss their wishes for EoL care. As with any treatment plan, unexpected circumstances are bound to appear, but the conversation can help steer physicians in the right direction when it comes to satisfying the patient's wishes.