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Cited by 70Palliative Care and End-of-Life IssuesGeriatric Care and Nursing HomesPalliative and Oncologic Care

Hospice Care for Patients With Dementia in the United States: A Longitudinal Cohort Study

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De Vleminck, Aline, Morrison, R. Sean, Meier, Diane E., Aldridge, Melissa D.·2018·Journal of the American Medical Directors Association
DOI 10.1016/j.jamda.2017.10.003PMC PMC5966338
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Abstract

BACKGROUND: Patients with dementia form an increasing proportion of those entering hospice care. Little is known about the types of hospices serving patients with dementia and the patterns of hospice use, including timing of hospice disenrollment between patients with and without dementia. OBJECTIVES: To characterize the hospices that serve patients with dementia, to compare patterns of hospice disenrollment for patients with dementia and without dementia, and to evaluate patient-level and hospice-level characteristics associated with hospice disenrollment. METHODS: We used data from a longitudinal cohort study (2008-2011) of Medicare beneficiaries (n = 149,814) newly enrolled in a national random sample of hospices (n = 577) from the National Hospice Survey and followed until death (84% response rate). RESULTS: A total of 7328 patients (4.9%) had a primary diagnosis of dementia. Hospices caring for patients with dementia were more likely to be for-profit, larger sized, provide care for more than 5 years, and serve a large (>30%) percentage of nursing home patients. Patients with dementia were less likely to disenroll from hospice in conjunction with an acute hospitalization or emergency department visit and more likely to disenroll from hospice after long enrollment periods (more than 165 days) as compared with patients without dementia. No significant difference was found between patients with and without dementia for disenrollment after shorter enrollment periods (less than 165 days). In the multivariable analyses, patients were more likely to be disenrolled after 165 days if they were served by smaller hospices and hospices that served a small percentage of nursing home patients. CONCLUSION: Patients with dementia are significantly more likely to be disenrolled from hospice following a long enrollment period compared with patients without dementia. As the number of individuals with dementia choosing hospice care continues to grow, it is critical to address potential barriers to the provision of quality palliative care for this population near the end of life.

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  • The average number of days of hospice care for individuals with a primary diagnosis of dementia was 50% higher than for individuals with other primary diagnoses, based on 2008-2011 National Hospice Survey data.

    “The average number of days of hospice care for individuals with a primary diagnosis of dementia was 50% higher than for individuals with other primary diagnoses, based on data from the 2008 to 2011 National Hospice Survey.768”

    From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [768]

  • Individuals with a primary diagnosis of dementia use an average of 112 days of hospice care versus 74 days for individuals with other primary diagnoses.

    “Individuals with a primary diagnosis of dementia use an average of 112 days of hospice care versus 74 days for individuals with other primary diagnoses.”

    From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [768]

  • Individuals with dementia are more likely to be disenrolled after more than 6 months in hospice than patients with other diagnoses.

    “researchers have found that individuals with dementia are more likely to be disenrolled after more than 6 months in hospice than patients with other diagnoses.768,771”

    From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [768]

  • The average number of days of hospice care for individuals with a primary diagnosis of dementia was 50% higher than for individuals with other primary diagnoses, based on data from the 2008 to 2011 National Hospice Survey.

    “The average number of days of hospice care for individuals with a primary diagnosis of dementia was 50% higher than for individuals with other primary diagnoses, based on data from the 2008 to 2011 National Hospice Survey. 926”

    From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [926]

  • Individuals with a primary diagnosis of dementia use an average of 112 days of hospice care versus 74 days for individuals with other primary diagnoses.

    “Individuals with a primary diagnosis of dementia use an average of 112 days of hospice care versus 74 days for individuals with other primary diagnoses.”

    From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [926]

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Authors
De Vleminck, A., Morrison, R. S., Meier, D. E., & Aldridge, M. D.
Affiliations
Icahn School of Medicine at Mount Sinai (US)
Corresponding author
Aldridge, Melissa D.
ORCID
Venue
Journal of the American Medical Directors Association
Publisher
Elsevier BV
Published
2018-07
Volume
19
Issue
7
Pages
633-638
ISSN
1525-8610 (ISSN-L)
DOI
10.1016/j.jamda.2017.10.003
PMC
PMC5966338
OpenAlex
W2770546374
Cited by
70
References
30
Citations by year
2026: 8 · 2025: 6 · 2024: 5 · 2023: 8 · 2022: 14 · 2021: 12 · 2020: 11 · 2019: 4 · 2018: 2
FWCI
4.36
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American Medical Directors Association (publishedVersion, other-oa)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • Ghent University Academic Bibliography (Ghent University) (submittedVersion)
  • VUBIR (Vrije Universiteit Brussel) (submittedVersion)
Funders
National Institute of Nursing Research (R01NR013499)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
Keywords
hospice care, dementia, nursing home residents, acute hospitalization, emergency department visits, palliative care, end-of-life care, Medicare beneficiaries
MeSH terms
Aged, Aged, 80 and over, Dementia, Female, Medicare, Hospices, Hospitalization, Humans, Length of Stay, Longitudinal Studies, Male, United States, Cohort Studies, Hospice Care

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