• Marc-Antoine Bornet, Rubli TruchardEveEPalliative and Supportive Care Service and Service of Geriatric Medicine and Geriatric Rehabilitation (M.-A.B., E.R.T., R.J.J.), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Service of Geriatric Medicin, Mathieu Bernard, Jérôme Pasquier, Gian Domenico Borasio, and Ralf J Jox.
• Palliative and Supportive Care Service and Service of Geriatric Medicine and Geriatric Rehabilitation (M.-A.B., E.R.T., R.J.J.), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. Electronic address: marc-antoine.bornet@chuv.ch.
• J Pain Symptom Manage. 2021 Nov 1; 62 (5): 902-909.

ContextThe will to live (WTL) is an important indicator of subjective well-being. It may enable a deeper understanding of the well-being of nursing home residents.ObjectivesTo evaluate the intensity of WTL, its association with various factors, and its temporal evolution among residents ≥ 65 years old; we also aimed to compare it with proxy assessments of WTL.MethodsA cross-sectional study was conducted in five nursing homes in Switzerland. Participants with decisional capacity were asked to rate the intensity of their WTL on a single-item numerical rating scale ranging from 0-10. A short-term follow-up was conducted among a sub-sample of 17 participants after three and six weeks. Proxy assessment by residents' next of kin and professional caregivers was conducted, and inter-rater agreement was calculated.ResultsData from 103 participants (75.7% women, 87.3 ± 8.0 years) was analyzed. The median intensity of WTL was 8. Higher WTL was significantly associated with better physical mobility and shorter duration of daily care but not with age, gender, pre-admission care setting, or prognosis. Significant independent predictors of WTL were physical mobility and provenance from rehabilitative care. In the short-term follow-up assessment, WTL remained highly stable. Intraclass correlation coefficients were moderate for residents' next of kin and nurse assistants but poor for physicians and nurses; all proxy assessments underestimated the participants' WTL.ConclusionNursing home residents expressed a very strong WTL and proxy aents underestimated residents' WTL. It seems pivotal to proactively communicate with residents about their WTL.Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

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