Abstract
The benefits of early referral to hospice services have been well documented. However, late admissions and short hospice stays are ongoing issues that are often barriers to improving terminally-ill persons’ and the caregivers’ quality of life and the quality of care. Using ordered logistic regression, this study analyzed the length of stay of 7,307 patients who died in 2015 while receiving care in the largest hospice agency in the DC metro region. Cancer diagnoses and residence in a higher median income neighborhood were associated with shorter lengths of stay. Female sex, older age, and residence in a lower median income neighborhood were associated with longer lengths of stay. The findings indicate that differences in demographic and diagnostic characteristics likely affect hospice length of stay.
Highlights
An increasing number of family caregivers face challenges of advance care planning (ACP) for their cognitively impaired older adults
Multilevel logistic regression models showed that local sociodemographic characteristics and healthcare characteristics were related to rates of ACP
The following environmental factors were moderated by both individual household income and educational attainment, Medicare physician reimbursement rate, racial/ethnic makeup, age composition, median household income, rurality, and the number of hospice agencies
Summary
An increasing number of family caregivers face challenges of advance care planning (ACP) for their cognitively impaired older adults. THE ROLE OF THE ENVIRONMENTAL CONTEXT IN ADVANCE CARE PLANNING AMONG OLDER ADULTS Brittany E. FAMILY CAREGIVERS’ ADVANCE CARE PLANNING FOR COGNITIVELY IMPAIRED OLDER ADULTS: SERVICE PROVIDERS’ PERSPECTIVES Hyunjin Noh,1 and Temilade A.
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