Hospice offers comfort for older adults at end of life. Should we consider it sooner?
A team of researchers from Yale University has studied how soon older adults who were experiencing distressing symptoms and disability were admitted to hospice near the end of their lives . Their study was published in the Journal of the American Geriatrics Society.
The researchers examined information from a study of 562 people, aged 70 and older, who were not disabled when the study began. Of these people, 244 (43.4 percent) were admitted to hospice during the last year of life. These people were slightly older and more likely to have cognitive impairments (problems thinking and making decisions) than those individuals who weren't admitted to hospice.
The most common condition leading to death was frailty (the medical term for physical weakness or an increasing likelihood for poor health), followed by organ failure (the term for certain parts of our body no longer working as they should), advanced dementia, and cancer.
The researchers found that cancer and advanced dementia were the conditions that most often resulted in being admitted for hospice care. Older adults who were frail were least likely to be admitted to hospice.
The duration of hospice care was less than 13 days for half of the study participants. The short duration of hospice suggests that healthcare providers might need to consider discussing referrals to hospice sooner with people who are approaching the end of their lives. Alternatively, we may need to develop and test other ways to reduce the high burden of distressing symptoms and disability at the end of life, said the researchers.
The researchers suggest that referral to hospice at the end of life should be based on an older adult's burden of pain and other distressing symptoms.
This summary is from "Distressing Symptoms, Disability and Hospice Services at the End of Life: Prospective Cohort Study." It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are Thomas M. Gill, MD; Ling Han, MD, PhD; Linda Leo-Summers, MPH; Evelyne A. Gahbauer, MD, MPH; and Heather G. Allore, PhD, from the Yale School of Medicine, Department of Internal Medicine, in New Haven, Conn.
About the Health in Aging Foundation
This research summary was developed as a public education tool by the Health in Aging Foundation. The Foundation is a national non-profit established in 1999 by the American Geriatrics Society to bring the knowledge and expertise of geriatrics healthcare professionals to the public. We are committed to ensuring that people are empowered to advocate for high-quality care by providing them with trustworthy information and reliable resources. Last year, we reached nearly 1 million people with our resources through HealthinAging.org. We also help nurture current and future geriatrics leaders by supporting opportunities to attend educational events and increase exposure to principles of excellence on caring for older adults. For more information or to support the Foundation's work, visit http://www.HealthinAgingFoundation.org.
About the Journal of the American Geriatrics Society
Included in more than 9,000 library collections around the world, the Journal of the American Geriatrics Society (JAGS) highlights emerging insights on principles of aging, approaches to older patients, geriatric syndromes, geriatric psychiatry, and geriatric diseases and disorders. First published in 1953, JAGS is now one of the oldest and most impactful publications on gerontology and geriatrics, according to ISI Journal Citation Reports®. Visit wileyonlinelibrary.com/journal/JGS for more details.
About the American Geriatrics Society
Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals that has — for 75 years — worked to improve the health, independence, and quality of life of older people. Its nearly 6,000 members include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists. The Society provides leadership to healthcare professionals, policymakers, and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy. For more information, visit AmericanGeriatrics.org.
Daniel E Trucil
Related Journal Article