Help! I Need Somebody: The Impact of Cognitive Status on Designating a Healthcare Proxy

The goal of this study is to understand the characteristics that make someone more likely to choose a healthcare proxy. Using five waves of the Health and Retirement Study, the authors use logistic regression models to examine the likelihood of designating a healthcare proxy, based on cognitive status and other demographic, social, and health factors. Results show several variables associated with lower odds of having a healthcare proxy, such as lower socioeconomic status, less active social life, and better health. Authors discuss how social workers can help identify at-risk patients and normalize conversations about end-of-life care preferences between healthcare professionals, patients, and families. Authors also discuss the importance of end-of-life care conversations between healthcare professionals and patients, and suggest more work is done to identify organizations that can serve as healthcare proxies for adults without support systems, as these adults have a greater likelihood of needing a legal guardian, which can be costly and create delays in care and hospital discharge.