Hospice care is short and may start later than needed

September 12, 2017, Yale University

Older adults are admitted to hospice for short duration despite experiencing symptoms months prior to the end of life, according to a Yale-led study. The finding highlights the need for earlier hospice admission or other strategies to address increasing symptoms and disability at the end of life, the researchers said.

The study was published on September 12 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 but died over the following 16 years. Of these individuals, 244 (43.4 percent) were admitted to hospice during the last year of . They were slightly older and more likely to have cognitive impairments (problems thinking and making decisions) than who weren't admitted to hospice.

The researchers found that cancer and advanced dementia were the conditions that most often resulted in hospice admission. Older adults who were frail were least likely to be admitted to hospice. The most common condition leading to death was frailty, followed by organ failure, advanced dementia, and cancer.

The study also found that the duration of was less than 13 days for half of the study participants. This short duration suggests that healthcare providers might need to consider discussing referrals to hospice sooner with people who are approaching the end of their lives. Alternatively, providers 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.

"Failing or delaying to refer to hospice at the end of life can place a high burden on caregivers and result in patient suffering," said Thomas Gill, M.D., the Humana Foundation Professor of Medicine and the study's first author.

Referral to at the end of life should be based on an older adult's burden of pain and other , suggest the researchers. Those symptoms include fatigue, nausea, depression, anxiety, difficulty sleeping, and difficulty with memory, among others.

Explore further: Five-year study sheds light on hospice care in assisted living facilities versus in the home

More information: Thomas M. Gill et al, Distressing Symptoms, Disability, and Hospice Services at the End of Life: Prospective Cohort Study, Journal of the American Geriatrics Society (2017). DOI: 10.1111/jgs.15041

Related Stories

Five-year study sheds light on hospice care in assisted living facilities versus in the home

July 6, 2015
Researchers have found several key differences among people who receive hospice care—which maintains or improves the quality of life for someone whose condition is unlikely to be cured—in assisted-living facilities (ALFs) ...

Why fewer blood cancer patients receive hospice care

May 22, 2017
Research has shown that patients with blood cancers are less likely to enroll in hospice care than patients with solid cancers, and the findings from a national survey suggest that concerns about the adequacy of hospice may ...

Factors ID'd for late hospice admission for cancer patients

September 1, 2014
(HealthDay)—For patients with cancer, factors associated with late admission to hospice have been identified, according to a study published online Aug. 25 in the Journal of Clinical Oncology.

Study compares hospice care in nursing homes, assisted living facilities and patient homes

March 23, 2017
A new study from the Indiana University Center for Aging Research and the Regenstrief Institute has found only minimal differences in the intensity of hospice services provided in nursing homes as compared to hospice services ...

Does Medicare/Medicaid incentive payment affect home hospice care in last week of life?

July 17, 2017
A new study has shown that the new Service Intensity Add-on (SIA) payment for in-person routine home hospice care during the last 7 days of life, which was added to Medicare/Medicaid coverage in 2016, could increase visits ...

Many with cancer hospitalized, undergo imaging at end of life

July 27, 2017
(HealthDay)—About half of cancer patients are hospitalized and undergo at least one imaging scan at the end of life, according to a study published online July 24 in the Journal of Oncology Practice.

Recommended for you

Americans are getting more sleep

January 19, 2018
Although more than one in three Americans still don't get enough sleep, a new analysis shows first signs of success in the fight for more shut eye. According to data from 181,335 respondents aged 15 and older who participated ...

Wine is good for you—to a point

January 18, 2018
The Mediterranean diet has become synonymous with healthy eating, but there's one thing in it that stands out: It's cool to drink wine.

Sleep better, lose weight?

January 17, 2018
(HealthDay)—Sleeplessness could cost you when it's time to stand on your bathroom scale, a new British study suggests.

Who uses phone apps to track sleep habits? Mostly the healthy and wealthy in US

January 16, 2018
The profile of most Americans who use popular mobile phone apps that track sleep habits is that they are relatively affluent, claim to eat well, and say they are in good health, even if some of them tend to smoke.

Improvements in mortality rates are slowed by rise in obesity in the United States

January 15, 2018
With countless medical advances and efforts to curb smoking, one might expect that life expectancy in the United States would improve. Yet according to recent studies, there's been a reduction in the rate of improvement in ...

Can muesli help against arthritis?

January 15, 2018
It is well known that healthy eating increases a general sense of wellbeing. Researchers at Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) have now discovered that a fibre-rich diet can have a positive influence ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.