A longitudinal study of retirement transition and advance directive completion

Abstract

Background and Objectives: Advance directives (AD) help to ensure patients' wishes are honored and contribute to improved end-of-life care. According to normative life course theory, retirement is a significant role change that signals a transition into the third age and its socially prescribed activities. This study tested whether transitioning from work to retirement prompted AD completion. Research Design and Methods: The sample included Health and Retirement Study participants who, in 2012, had no ADs and were not completely retired (N = 919). Three waves of data were analyzed using multinomial logistic regression to test associations between retirement transition and advance directive completion. Results: By 2014, 21% had completed ADs and another 17% completed them by 2016. Those who completely retired between 2012 and 2014 were almost twice as likely to complete ADs between 2014 and 2016. Graduated increase in level of retirement between 2012 and 2014 was associated with higher odds of new AD possession in 2016, but did not reach statistical significance at p < .05. Discussion and Implications: The period following retirement may be an optimal time to encourage patients and clients who have not already done so to complete advance directives.