AI Article Synopsis
- The study explores trends in the place of death for individuals with Alzheimer’s disease-related dementias (ADRD) from 2003 to 2017, noting a shift toward dying at home or in hospice facilities rather than in hospitals or nursing facilities.
- Key findings show a decline in nursing facility and hospital deaths, with rising deaths at home and in hospice care, as well as significant demographic influences such as age, sex, race, and education on these trends.
- The conclusion suggests an increasing need for support in home care and palliative services as more ADRD patients die at home, highlighting areas for further research on caregiver experiences and financial implications of these trends.
Article Abstract
Objectives: To assess trends and factors associated with place of death among individuals with Alzheimer's disease-related dementias (ADRD).
Design: Cross-sectional analysis.
Setting: Centers for Disease Control and Prevention Wide-ranging OnLine Data for Epidemiologic Research, 2003-2017.
Participants: Natural deaths occurring between 2003 and 2017 for which ADRD was determined to be the underlying cause.
Measurements: Place of death was categorized as hospital, home, nursing facility, hospice facility, and other. Aggregate data included age, race, Hispanic ethnicity, sex, urbanization, and census division. Individual-level predictors included age, race, Hispanic ethnicity, sex, marital status, and education.
Results: From 2003 to 2017, nursing facility and hospital deaths declined from 65.7% and 12.7% to 55.0% and 8.0% while home and hospice facility deaths increased from 13.6% and .2% to 21.9% and 6.2%, respectively. Odds of hospital and hospice facility deaths declined with age while odds of nursing facility deaths increased with age. Male sex was associated with higher odds of hospital or hospice facility death and lower odds of home or nursing facility death. Nonwhite race, Hispanic ethnicity, and being married were associated with increased odds of hospital or home death and reduced odds of nursing facility death. More education was associated with higher odds of home or in a hospice facility death and reduced odds of death in a nursing facility or hospital. Significant disparities in place of death by urban-rural status were also noted.
Conclusion: As ADRD deaths at home increase, the need for caregiver support and home-based palliative care may become more critical. Further research should examine the care preferences and experiences of ADRD patients and caregivers, the financial impact of home death on families and insurers, and explore factors that may contribute to differences in actual and preferred place of death. J Am Geriatr Soc 68:250-255, 2020.
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| http://dx.doi.org/10.1111/jgs.16200 | DOI Listing |
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