Midlife and Older Chinese Adults’ Preferences for End-of-Life Care Decision-Making: Patterns and Correlates

We used latent class analysis to identify profiles of midlife and older Chinese adults' preferences regarding involvement in three dimensions of end-of-life care: information exchange, deliberation, and decisional control. Data are from 548 urban and rural Shanghai residents aged 50+. We used multinomial logistic regression to evaluate associations between individual- and family-oriented beliefs and latent class membership. We identified four profiles. Lead decision-makers (49%) prefer to take charge of information exchange and final decisions, while valuing collaborative discussions. Autonomous decision-makers (19%) prefer making decisions without others' input. Delegating decision-makers (16%) prefer that family or doctors decide. Acquiescent decision-makers (15%) prefer to follow their family's wishes if discrepant preferences exist. Among family-oriented values, only strong extended familism beliefs were associated with delegating decision-making. Individuals' desire for a "good death" was strongly linked to independent decision-making. Practitioners should assess, understand, and develop practices to ensure decision-making preferences are met in Chinese families.