According to a CHCF survey of Californians conducted in late 2011, a large majority say they would prefer a natural death if they became severely ill, rather than have all possible medical interventions provided. They would prefer to die at home instead of in a hospital or nursing home. And they want to talk with their doctor about their wishes for care at the end of life. However, Californians don't always get what they want, as this research shows.

Among the highlights:

• Californians say the most important factors at the end of their lives are making sure their families are not burdened financially by the costs of care (67% say this is extremely important) and being comfortable and without pain (66%).
• Sixty percent say that making sure their families are not burdened by tough decisions about their care is "extremely important." However, 56% of Californians have not communicated their end-of-life wishes to the loved one they would want making decisions on their behalf.
• While a large majority of Californians (82%) say it is important to have end-of-life wishes in writing, only 23% say they have done so.
• When people hear about a new approach called Physician Orders for Life-Sustaining Treatment (POLST), most want to use the process to document their preferences.
• Almost 80% say they definitely or probably would like to talk with a doctor about end-of-life care, but only 7% have had a doctor speak with them about it. Over 80% think it would be a very or somewhat good idea for doctors to be paid for such discussions.
• Seventy percent of Californians say they would prefer to die at home. However, of deaths in California in 2009, 32% occurred at home, 42% in a hospital, and 18% in a nursing home.

The snapshot is available as a Document Download. Also available are videos with individuals' reflections on death and dying, along with helpful resources, under the Related CHCF Page below.