Studies have shown that patients with advanced care planning (ACP), such as a living will, were more likely to receive end-of-life care consistent with their preferences and greater use of hospice and palliative care. Less is known about the rates of ACP use between veteran and non-veteran older Americans.

The Harmonized End of Life dataset is a linked collection of variables derived from the Health and Retirement Study (HRS) Exit interviews between 1994 and 2014. Only male decedents were included in the current analysis (N=4,828), because of very few female veterans in the data. Having an established living will was measured by asking the proxy, “whether the deceased respondent ever provided written instructions about the treatment or care he/she wanted to receive during the final days of his/her life.” Veteran status was determined by the item, "Have you ever served in the active military of the United States?" at their first HRS interview.

While there was no difference in having an established living will between veteran and non-veteran decedents among deaths occurred before 2004, veterans who died during the second half of the study (2004 to 2014) were more likely to have an established living than those of non-veteran decedents (OR=1.3, p<.01).

Our findings suggest a higher use of ACP among deceased veterans between 2004 and 2014. Future studies are needed to determine if the higher use of ACP is associated with better access and quality of end of Life care provided by the Veterans Health Administration.