In the last several years, I have seen increased requests from SNF and ALF residents and their families for more information about MAID (Medical Aid-in-Dying) in California.

Since the California End of Life Option Act became effective June 9, 2016, CDPH has been publishing an annual report in July on the use of this option in California that reflects the prior year’s activity. The 2024 report can be found online, click here for access.

Highlights you may find interesting include:

1. 1,591 individuals received prescriptions under EOLA.
1. 221 or 13.9% died of their underlying illness or other causes.
2. 1,032 individuals died following their ingestion of the prescribed aid-in-dying drugs(s), which included 50 individuals who received prescriptions prior to 2024.
1. Of the 1,032 individuals:
1. 92.1% were 60 y/o or older.
2. 97% had health insurance.
3. 94.8% were receiving hospice and or palliative care.
3. A total of 346 physicians prescribed aid-in-dying drugs.
4. The most common combination drug categories were cardiotonic, opioid, and sedative.
5. The most common terminal illness categories were:
1. Cancer - 60%
2. CVDz - 10.3%
3. Neurologic - 10.2%
4. Respiratory – 6.3%
5. Other – 9.8%
6. Place of death:
1. Private home – 85.3%
2. Assisted living – 7.3%.
3. Nursing Home – 2.3%
4. In-patient Hospice – 1.5%
5. Acute Care Hospital .1%
6. Unknown – 3.1%

Please see the above link for a wealth of other valuable demographic information.

Since the Law became effective June 9, 2016, through December 31, 2024

1. 8,242 individuals have received prescriptions under the EOLA.
2. 5,423 individuals, or 65.8%, have died from ingesting the medications.
3. The individuals dying from EOLA drugs has about doubled in the last 3 years.

I hope that our California legislature continues to fund CDPH to collect the data and create the annual report. This is dependent on legislative funding, which no longer occurs in the state of Washington. These and other data have helped advance the practice and science of MAID.

The Academy of Aid-in-Dying has an updated website and blog that promotes the development of best MAID practices. On July 31, 2025, Lonny Shavelson, MD, and Thalia DeWolf, RN, CHPN published “Advances in Aid-in-Dying Clinical Care”, which I commend to your review.

Are you or your facility aware of the details of the EOLA legislation? In acute hospital, hospice, and SNF settings, open written disclosure of your participation or non-participation status is required; and it is recommended in the ALF setting. Are your policies and procedures up to date?

As you can see from the latest statistics, more residents in ALFs and NFs are accessing this option. Please prepare to manage these requests with excellence.