A significant number of Americans die in ways that do not reflect their preferences for end-of-life (EOL) care. For married individuals, the spouse often has the legal authority to make decisions at EOL. Many factors, most notably open preemptive communication about care preferences and dying wishes, determine whether such communication is viable and a partner’s wishes are respected. We used a mixed method approach, involving a content analysis of spouses’ reasons for seeking and avoiding conversations regarding their partners’ EOL care preferences, and examined whether certain demographic factors (eg, income, gender, age) more likely contributed to the initiation of EOL conversations. We situate our findings within the broader cultural discourse about death and dying and highlight the influence of uncertainty in spousal EOL communication.
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