Life expectancy for Americans declined. Deaths from violent crimes in the U.S. continue to grow. Catastrophic weather events resulted in more than 1,000 deaths in the past two years. Under such turmoil, more people were prompted to prepare for medical emergencies earlier than ever—regardless of age.
LegalTemplates surveyed over 10,000 adults from four different generations—Baby Boomers (born 1946-64), Gen X (born 1965-80), Millennials (born 1981-96), and Gen Z (born 1997-2012)—who completed their medical power of attorney in 2022. We examined the healthcare decisions they made and how the decisions are different across the generations. Of all generations, young adults of Gen Z accounted for nearly one-fourth of the total document creation count, which is more than that of Gen X (19%) or Millennials (16%).
Read on to learn more about how different generations choose their healthcare agents, give authority, and make end-of-life decisions.
Demographics of the Principals
In a medical power of attorney, the principal is the person who appoints a healthcare agent and specifies what authorities the agent has when making healthcare decisions.
Generational Distribution
Of all medical power of attorneys created in 2022 on LegalTemplates, almost half of the principals were Baby Boomers. Surprisingly, the generation that placed second in terms of principal count is Gen Z.
Despite only accounting for roughly 20% of the U.S. population, Gen Z created more medical power of attorney documents than Millennials and Gen X (born 1965-80).
The unexpectedly high number of documents created by Gen Z may seem odd at first. Statistics show that Gen Z only accounted for less than 1% of total deaths occurred on average. Nevertheless, the FBI revealed alarming data in their 2021 Violent Crime Report: almost 30% of all violent crime victims were between 20 to 29 years old.
“In most states, individuals at age 18 are no longer minors but adults under the eyes of the law, which means they can make their own medical decisions.” Attorney Susan Chai explained, “Their parents or guardians have no rights or limited rights over them, including their health and medical records. It’s important for individuals who just turned 18 to create a Medical Power of Attorney and appoint a trusted person as the agent, such as their parents.”
Gender Distribution among Principals
For Baby Boomers, Gen X, and Millennials principals, we found more females (~56%) than males (~44%) when combining the figures. It may be safe to say that such a finding is within expectation, as studies have shown that women are more risk-averse than men and tend to plan.
However, the male-female ratio for medical power of attorney users was found to be reversed for Gen Z. In other words, there were more Gen Z male principals (55%) than Gen Z women principals (45%).
So what could have motivated Gen Z men to prepare in advance more than their opposite sex? Again, the FBI Violent Crime Report 2021 provides a possible answer. There is an exceptionally high proportion of homicide victims from the age group of 20-29 compared to other age groups; furthermore, almost 80% of homicide victims were men.
Who Are the Healthcare Agents?
A healthcare agent appointed by a medical power of attorney is authorized to make healthcare decisions for the principal. This can include admittance or discharge from healthcare facilities, life support, tissue/organ donation, and many more.
Gender Distribution among Agents
Our findings reveal that females were significantly more favored as healthcare agents across all generations. In particular, almost 80% of Gen Z principals appointed a woman as their healthcare agent.
Considering the magnitude of authority given to their healthcare agents, it is understandable that most (if not all) principals prefer their agents to be empathetic and trustworthy. And women, as research suggests, are generally more adept at empathy than men, which may have explained such preference.
Family vs Friends
Apart from Gen Z, only around 40% of principals appoint a family member or partner as their healthcare agent. This means that more than half of the people prefer to have friends or other unrelated closed ones to make important healthcare decisions for them.
By contrast, two-thirds of Gen Z selected a family member or partner as their healthcare agent. It is possible that most Gen Z principals appoint their parents or other senior family members as their healthcare agents since their friends are usually of similar or the same age, lacking sufficient life experience and mental maturity to make decisions on various (and sometimes difficult) healthcare matters.
On the other hand, Millennials are the least likely to appoint a family member as their healthcare agent. There could be various reasons, including their relatively low marriage rate compared to that of Gen X and Baby Boomers, and that they are much less likely to live with a family of their own than Gen Xers and Baby Boomers.
Geographic Proximity
Geographic proximity is usually deemed one of the deciding factors when appointing a healthcare agent. After all, it could be difficult for anyone to make healthcare decisions on behalf of another person if the two are miles apart.
Our findings indicate that around 90% of people and their healthcare agents live in the same state in general. In addition, more than half of the agents live in the same city as their principals.
Among all generations, Gen Z is found to have their healthcare agents a lot closer compared to other generations. This phenomenon is not surprising given a U.S. Census Bureau report highlights the fact that 56% of adults aged 18 to 24 still live with their parents. On the contrary, older populations are more inclined to live alone.
Powers Granted
Bodily Integrity
It is apparent that principals from the older generations are more unwilling to give the power to allow participation in medical research and make decisions regarding organ/tissue donation. This may be due to the desire to maintain bodily integrity, misunderstandings of medical procedures from medical misrepresentation in the media, or simply distrust in the medical system.
On the other hand, Gen Z principals are significantly more open to giving their agents authority regarding donating their organs/tissues and using their bodies for medical research.
This finding partially matches statistics from the 2019 National Survey of Organ Donation Attitudes and Practices report, which indicates that the age group 18-34 is more willing to donate organs after death than other senior age groups.
Special Instructions and the Will to Live
Principals can include special instructions in their medical power of attorney to further detail their healthcare wishes. Among all generations, millennials have the highest ratio of including special instructions at a rate of 22%. On the other hand, only 10% of Gen Z principals chose to include special instructions.
In terms of instructions to prolong life, 12.1% of Baby Boomers specifically indicate they do not wish life extended by extraordinary means beyond comfort care. This was the most among all generations. Millennials included similar instructions only 2.9% of the time.
August: The Peak Season for Gen Z
In 2022, nearly 30% of all medical power of attorney forms created by Gen Z were from August—a trend that the other three generations seem not to demonstrate.
This phenomenon could be due to the fact that schools and colleges start around the same time. In fact, most estate planning attorneys advise college students to prepare their medical power of attorney documents before going away from home to college.
“College is overwhelming, and having a medical power of attorney in place can alleviate stress for college students when they’re sick or facing the need for medical records by asking their agents (usually mom and dad) to help care for them,” Chai stressed.
Along with leaving home for the first time, campus violence could be another driving factor for such a spike. Statistics show that there have been ten mass shootings on college campuses since 1966 and 96 school shootings with casualties in primary and secondary schools from 2021 to 2022, the highest number in 20 years.
Given the high numbers, it is reasonable that nearly two-thirds of college students are concerned about their safety on campus, which could motivate them to prepare for the worst.
Prepare Ahead
More Gen Zers have started to realize the importance of planning ahead. On the other hand, incapacitation might seem too “far away” for Millennials and Gen Xers to think about as most of them “felt healthy” and therefore do not see the necessity to prioritize estate planning at their current stages of life.
But the truth is no one can predict when a tragic accident or violent incident will occur. In fact, the CDC notes that accidents ranked as the fourth leading cause of death in 2021. For Gen Z and Millennials, accidents actually ranked first, while assault (homicide) ranked third.
It is never too early to legally document your preferred healthcare wishes and discuss them with someone you trust. If you have not created a medical power of attorney, LegalTemplates has a great portfolio of estate planning for easy access across all generations.
