Consenting to Die

Research has indicated that the presence of a primary caregiver may influence a patient’s decision to receive hospice care, but how and to what extent remains unclear. This study explores whether the presence of a caregiver affects a patient’s election of hospice care. The analysis uses data from the 1993 National Mortality Followback Survey to examine the probability of hospice user among people ages 15 and older who died from non-traumatic causes in that year. The key independent variable of interest was the presence of a caregiver, defined as someone who provided unpaid help taking care of the decedent or performing routine chores. Logistic regression results indicate that the presence of caregivers is strongly correlated with the decision to receive hospice care. The odds of individuals with caregivers using hospice services are between 2 and nearly 4 times as great as for those who need caregivers but are unable to obtain one. Policies that focus on hospice use must take into account the presence (or lack thereof) and potential effects of caregivers on patients.