Preference for Place of Death in a Continuing Care Retirement Community

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Abstract
Purpose: To describe death-related planning and preferences for place of death among well elders in a community characterized by a low rate of hospital deaths. Design and Methods: Cross-sectional prevalence survey of independent-living residents (n = 219) of a continuing-care retirement community (CCRC) in Central North Carolina characterized by a low rate of hospital deaths. Results: Death-related planning played a part in the decision of 40% of residents to move to the CCRC. A majority of residents reported a clear preference for place of death, and a majority of these preferred to die on the CCRC campus. Most residents wanted to discuss their preferences for place of death with their health care provider. Preferences for place of death appear consistent across age cohorts and are relevant to elders' long-term care decisions. Implications: Given the striking discrepancy between patients' preferences for nonhospital deaths and the high prevalence of hospital deaths in the United States, this often-neglected issue should be routinely addressed in end-of-life planning. The CCRC may be a practice model that is particularly compatible with personal preferences for place of death.