“Quality of life matters to me more than life, itself”: A qualitative exploration of older adults’ values and preferences on controlling the time of death

This study explored healthy older adults' values and preferences for controlling time of death and if these preferences change with hypothetical future disease. We used an interpretive descriptive approach to analyze open text responses (N = 121) from a national study on end-of-life values and preferences (age ≥ 50, N = 517). Codes/categories were developed deductively by three coders who engaged in ongoing conversation about discrepancies and refined the codes iteratively. Controlling time of death and having a natural death were both desirable care preferences and varied with hypothetical future disease. We identified three values that shaped preferences: A Good Death, Burden to Others, and Relationship with Family. We also identified two contextual factors that modified preferences: Disease Trajectory and Legal Concerns. We found that a hypothetical future diagnosis of dementia and anticipation of financial burden to family motivated preferences to control time of death.