Hospice care in assisted living facilities versus at home: Results of a multisite cohort study

Meredith Dougherty, Pamela S. Harris, Joan Teno, Amy M. Corcoran, Cindy Douglas, Jackie Nelson, Deborah Way, Joan E. Harrold, David J. Casarett

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objectives To compare residents of assisted living facilities receiving hospice with people receiving hospice care at home. Design Electronic health record-based retrospective cohort study. Setting Nonprofit hospices in the Coalition of Hospices Organized to Investigate Comparative Effectiveness network. Participants Individuals admitted to hospice between January 1, 2008, and May 15, 2012 (N = 85,581; 7,451 (8.7%) assisted living facility, 78,130 (91.3%) home). Measurements Hospice length of stay, use of opioids for pain, and site of death. Results The assisted living population was more likely than the home hospice population to have a diagnosis of dementia (23.5% vs 4.7%; odds ratio (OR) = 13.3, 95% confidence interval (CI) = 12.3-14.4; P <.001) and enroll in hospice closer to death (median length of stay 24 vs 29 days). Assisted living residents were less likely to receive opioids for pain (18.1% vs 39.7%; OR = 0.33, 95% CI = 0.29-0.39, P <.001) and less likely to die in an inpatient hospice unit (9.3% vs 16.1%; OR = 0.53, 95% CI = 0.49-0.58, P <.001) or a hospital (1.3% vs 7.6%; OR = 0.16, 95% CI = 0.13-0.19, P <.001). Conclusion Three are several differences between residents of assisted living receiving hospice care and individuals living at home receiving hospice care. A better understanding of these differences could allow hospices to develop guidelines for better coordination of end-of-life care for the assisted living population.

Original languageEnglish (US)
Pages (from-to)1153-1157
Number of pages5
JournalJournal of the American Geriatrics Society
Volume63
Issue number6
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

Fingerprint

Assisted Living Facilities
Hospice Care
Hospices
Cohort Studies
Odds Ratio
Confidence Intervals
Opioid Analgesics
Length of Stay
Population
Pain
Terminal Care
Electronic Health Records
Dementia
Inpatients
Retrospective Studies
Guidelines

Keywords

  • assisted living
  • hospice
  • palliative care

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Dougherty, M., Harris, P. S., Teno, J., Corcoran, A. M., Douglas, C., Nelson, J., ... Casarett, D. J. (2015). Hospice care in assisted living facilities versus at home: Results of a multisite cohort study. Journal of the American Geriatrics Society, 63(6), 1153-1157. https://doi.org/10.1111/jgs.13429

Hospice care in assisted living facilities versus at home : Results of a multisite cohort study. / Dougherty, Meredith; Harris, Pamela S.; Teno, Joan; Corcoran, Amy M.; Douglas, Cindy; Nelson, Jackie; Way, Deborah; Harrold, Joan E.; Casarett, David J.

In: Journal of the American Geriatrics Society, Vol. 63, No. 6, 01.01.2015, p. 1153-1157.

Research output: Contribution to journalArticle

Dougherty, M, Harris, PS, Teno, J, Corcoran, AM, Douglas, C, Nelson, J, Way, D, Harrold, JE & Casarett, DJ 2015, 'Hospice care in assisted living facilities versus at home: Results of a multisite cohort study', Journal of the American Geriatrics Society, vol. 63, no. 6, pp. 1153-1157. https://doi.org/10.1111/jgs.13429
Dougherty, Meredith ; Harris, Pamela S. ; Teno, Joan ; Corcoran, Amy M. ; Douglas, Cindy ; Nelson, Jackie ; Way, Deborah ; Harrold, Joan E. ; Casarett, David J. / Hospice care in assisted living facilities versus at home : Results of a multisite cohort study. In: Journal of the American Geriatrics Society. 2015 ; Vol. 63, No. 6. pp. 1153-1157.
@article{3b99814ead104f02b4c3cda99de33e9a,
title = "Hospice care in assisted living facilities versus at home: Results of a multisite cohort study",
abstract = "Objectives To compare residents of assisted living facilities receiving hospice with people receiving hospice care at home. Design Electronic health record-based retrospective cohort study. Setting Nonprofit hospices in the Coalition of Hospices Organized to Investigate Comparative Effectiveness network. Participants Individuals admitted to hospice between January 1, 2008, and May 15, 2012 (N = 85,581; 7,451 (8.7{\%}) assisted living facility, 78,130 (91.3{\%}) home). Measurements Hospice length of stay, use of opioids for pain, and site of death. Results The assisted living population was more likely than the home hospice population to have a diagnosis of dementia (23.5{\%} vs 4.7{\%}; odds ratio (OR) = 13.3, 95{\%} confidence interval (CI) = 12.3-14.4; P <.001) and enroll in hospice closer to death (median length of stay 24 vs 29 days). Assisted living residents were less likely to receive opioids for pain (18.1{\%} vs 39.7{\%}; OR = 0.33, 95{\%} CI = 0.29-0.39, P <.001) and less likely to die in an inpatient hospice unit (9.3{\%} vs 16.1{\%}; OR = 0.53, 95{\%} CI = 0.49-0.58, P <.001) or a hospital (1.3{\%} vs 7.6{\%}; OR = 0.16, 95{\%} CI = 0.13-0.19, P <.001). Conclusion Three are several differences between residents of assisted living receiving hospice care and individuals living at home receiving hospice care. A better understanding of these differences could allow hospices to develop guidelines for better coordination of end-of-life care for the assisted living population.",
keywords = "assisted living, hospice, palliative care",
author = "Meredith Dougherty and Harris, {Pamela S.} and Joan Teno and Corcoran, {Amy M.} and Cindy Douglas and Jackie Nelson and Deborah Way and Harrold, {Joan E.} and Casarett, {David J.}",
year = "2015",
month = "1",
day = "1",
doi = "10.1111/jgs.13429",
language = "English (US)",
volume = "63",
pages = "1153--1157",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
publisher = "Wiley-Blackwell",
number = "6",

}

TY - JOUR

T1 - Hospice care in assisted living facilities versus at home

T2 - Results of a multisite cohort study

AU - Dougherty, Meredith

AU - Harris, Pamela S.

AU - Teno, Joan

AU - Corcoran, Amy M.

AU - Douglas, Cindy

AU - Nelson, Jackie

AU - Way, Deborah

AU - Harrold, Joan E.

AU - Casarett, David J.

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Objectives To compare residents of assisted living facilities receiving hospice with people receiving hospice care at home. Design Electronic health record-based retrospective cohort study. Setting Nonprofit hospices in the Coalition of Hospices Organized to Investigate Comparative Effectiveness network. Participants Individuals admitted to hospice between January 1, 2008, and May 15, 2012 (N = 85,581; 7,451 (8.7%) assisted living facility, 78,130 (91.3%) home). Measurements Hospice length of stay, use of opioids for pain, and site of death. Results The assisted living population was more likely than the home hospice population to have a diagnosis of dementia (23.5% vs 4.7%; odds ratio (OR) = 13.3, 95% confidence interval (CI) = 12.3-14.4; P <.001) and enroll in hospice closer to death (median length of stay 24 vs 29 days). Assisted living residents were less likely to receive opioids for pain (18.1% vs 39.7%; OR = 0.33, 95% CI = 0.29-0.39, P <.001) and less likely to die in an inpatient hospice unit (9.3% vs 16.1%; OR = 0.53, 95% CI = 0.49-0.58, P <.001) or a hospital (1.3% vs 7.6%; OR = 0.16, 95% CI = 0.13-0.19, P <.001). Conclusion Three are several differences between residents of assisted living receiving hospice care and individuals living at home receiving hospice care. A better understanding of these differences could allow hospices to develop guidelines for better coordination of end-of-life care for the assisted living population.

AB - Objectives To compare residents of assisted living facilities receiving hospice with people receiving hospice care at home. Design Electronic health record-based retrospective cohort study. Setting Nonprofit hospices in the Coalition of Hospices Organized to Investigate Comparative Effectiveness network. Participants Individuals admitted to hospice between January 1, 2008, and May 15, 2012 (N = 85,581; 7,451 (8.7%) assisted living facility, 78,130 (91.3%) home). Measurements Hospice length of stay, use of opioids for pain, and site of death. Results The assisted living population was more likely than the home hospice population to have a diagnosis of dementia (23.5% vs 4.7%; odds ratio (OR) = 13.3, 95% confidence interval (CI) = 12.3-14.4; P <.001) and enroll in hospice closer to death (median length of stay 24 vs 29 days). Assisted living residents were less likely to receive opioids for pain (18.1% vs 39.7%; OR = 0.33, 95% CI = 0.29-0.39, P <.001) and less likely to die in an inpatient hospice unit (9.3% vs 16.1%; OR = 0.53, 95% CI = 0.49-0.58, P <.001) or a hospital (1.3% vs 7.6%; OR = 0.16, 95% CI = 0.13-0.19, P <.001). Conclusion Three are several differences between residents of assisted living receiving hospice care and individuals living at home receiving hospice care. A better understanding of these differences could allow hospices to develop guidelines for better coordination of end-of-life care for the assisted living population.

KW - assisted living

KW - hospice

KW - palliative care

UR - http://www.scopus.com/inward/record.url?scp=84931340232&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84931340232&partnerID=8YFLogxK

U2 - 10.1111/jgs.13429

DO - 10.1111/jgs.13429

M3 - Article

C2 - 26096389

AN - SCOPUS:84931340232

VL - 63

SP - 1153

EP - 1157

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

SN - 0002-8614

IS - 6

ER -