End-of-life treatment Choices and Spousal Impoverishment

A few recent studies suggest that out-of-pocket health care expenditures incurred prior to the death of a spouse may affect the subsequent probability of spousal impoverishment, especially for widowed women.  These studies, however, do not distinguish among couples who endured a lifetime of poverty, those whose joint resources immunize a surviving spouse from poverty, and those whose resources are inadequate to buffer the surviving spouse from a late life episode of poverty. In this latter group, couples may attempt to prevent drastic wealth depletion by foregoing or limiting treatment for the first spouse to encounter a potentially fatal disease. to The proposed research uses the AHEAD 1995 Module 6 (Living Wills) and HRS 1996 Module 7 (Advanced Directives), as well as data from the Core HRS, to analyze both the expressed preference (in terms of desire for life-prolonging treatment from a hypothetical scenario) and the revealed preference (in terms of wealth depletion for medical treatment) in spouses' treatment decisions prior to death.