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J Pain Symptom Manage · Sep 2022
The association between race and place of death among persons with dementia.
- Inbal Mayan, Kristine Yaffe, Jennifer James, and Lauren J Hunt.
- Global Brain Health Institute (I.M.), University of California, San Francisco, CA, USA; Tel Aviv University Sackler School of Medicine (I.M.), Ramat Aviv, Israel. Electronic address: Inbal.Mayan@gbhi.org.
- J Pain Symptom Manage. 2022 Sep 1; 64 (3): e109e114e109-e114.
ContextLittle is known about racial differences in place of death for persons with dementia (PWD), who may be especially vulnerable to receiving care at end of life that is not concordant with their goals or that places higher burden on caregivers.ObjectivesTo determine if there are racial and ethnic differences in place of death among PWD.MethodsWe analyzed data from the nationally representative National Health and Aging Trends study. Participants were included if they had probable dementia as defined by a previously validated algorithm and died between 2012 and 2020. Race and ethnicity were self-reported. Place of death was obtained from post-mortem interviews with bereaved caregivers.ResultsThe sample included 993 decedents with dementia (81.4% white; 11.0% black, 7.6% hispanic). A higher percentage of black and hispanic decedents died in the hospital (30.3% and 32.8%, respectively) compared to white decedents (19.0%). A higher percentage of white decedents died in the nursing home (31.0%) than black (22.4%) or hispanic decedents (15.0%) In adjusted analyses, black decedents had a higher odds of hospital death (AOR 1.50; 95% CI 1.01, 2.24) compared to white decedents, with similar trends found for hispanic decedents.ConclusionWe found racial and ethnic differences in location of death for PWD, with black and hispanic PWD more likely to die in the hospital compared to white PWD. More research is needed to determine if the differences found represent goal concordant care or rather lack of access to high quality of care at the end of life.Copyright © 2022 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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