Help! I Need Somebody: The Impact of Cognitive Status on Designating a Healthcare Proxy.

This study examines factors influencing the likelihood of adults aged 65 and older designating a healthcare proxy, a legal arrangement allowing a chosen individual to make medical decisions if the adult becomes incapacitated. Using data from five waves of the Health and Retirement Study, the research finds that adults with dementia, higher socioeconomic status (including education, income, and assets), poorer health, and more frequent social activities are more likely to have a healthcare proxy, while those who work for pay, are younger, male, or from racial/ethnic minority groups are less likely. Having a will is the strongest predictor, increasing the odds of designating a proxy sixfold. The study highlights the role of social workers in identifying at-risk adults, facilitating advance care planning conversations, and advocating for surrogate decision makers, especially for individuals without family or social support who may otherwise require costly and delayed court-appointed guardianship.