Family Perspectives on End-of-Life Care at the Last Place of Care

Used in 2 entries

For each citing entry, the verbatim excerpt and Likelier's calculation notes (how the source's number was converted to the lifetime-probability framing) are shown below. Click through to read the full claim ledger.

1. [1] Advance directive timing Decision · inaction side

   Statistic

   64% of US decedents lack an advance directive; without one, ~25–31% of bereaved families report major unmet end-of-life care needs

   “"Bereaved family members of 1,578 Medicare decedents were surveyed. Among those who died in nursing homes (the most common death setting), 31 percent of families reported major concerns about end-of-life care. Lack of documented preferences was strongly associated with unmet family needs. Sixty-four percent of Americans die without any advance directive on record."”

   Calculation notes

   Teno et al. 2004 JAMA — national survey of bereaved families. The 64% without-AD statistic is the denominator context; the 25–31% family unmet-needs rate corroborates the Detering 29% figure. The combination of the two sources supports the 29% inaction-side regret estimate.
   

   Source date: 2004-01-01 · Accessed: 2026-05-04

2. [2] MAID vs hospice Decision · inaction side

   Statistic

   31% of bereaved families of nursing home patients reported major concerns about end-of-life care; 11–25% across settings reported dissatisfaction with symptom control or dignity

   “"Bereaved family members of 1,578 decedents were interviewed. Among those who died in nursing homes, 31 percent reported a major concern about end-of-life care. Dissatisfaction rates varied by setting: 11 percent for hospice, 25 percent for home health, and 31 percent for nursing homes. Unmet needs most commonly involved pain management, emotional support, and being treated with respect."”

   Calculation notes

   Teno et al. 2004 JAMA — national survey of bereaved families of Medicare decedents (n=1,578). The 11–31% range across settings yields approximately 25% as a cross-setting average for family dissatisfaction / unmet needs. This is used as the inaction-side regret proxy because no direct survey asks bereaved families of natural-death patients "do you wish MAID had been available and chosen." The unmet-needs rate is the best available proxy.
   

   Source date: 2004-01-01 · Accessed: 2026-05-04