Quality of hospice care for individuals with dementia

Jennifer S. Albrecht, Ann L. Gruber-Baldini, Erik K. Fromme, Jessina C. McGregor, David S.H. Lee, Jon P. Furuno

    Research output: Contribution to journalArticle

    20 Scopus citations

    Abstract

    Background Patients with dementia constitute an increasing proportion of hospice enrollees, yet little is known about the quality of hospice care for this population. The aim of this study was to quantify differences in quality of care measures between hospice patients with and without dementia. Design Cross-sectional analysis of data. Setting 2007 National Home and Hospice Care Survey. Participants Four thousand seven hundred eleven discharges from hospice care. Measurements A primary diagnosis of dementia at discharge was defined according to International Classification of Diseases, Ninth Revision, codes (290.0-290.4x, 294.0, 294.1, 294.8, 331.0-331.2, 331.7, and 331.8). Quality-of-care measures included enrollment in hospice in the last 3 days of life, receiving tube feeding, depression, receiving antibiotics, lack of advanced directive or do not resuscitate order, Stage II or greater pressure ulcers, emergency care, lack of continuity of residence, and a report of pain at last assessment. Results Four hundred fifty (9.5%) individuals were discharged with a primary diagnosis of dementia. In multivariable analysis, individuals with dementia were more likely to receive tube feeding (odds ratio (OR) = 2.6, 95% confidence interval (CI) = 1.4-4.5) and to have greater continuity of residence (OR = 1.8, 95% CI = 1.1-3.0) than other individuals in hospice and less likely to have a report of pain at last assessment (OR = 0.6, 95% CI = 0.3-0.9). Conclusions The majority of quality-of-care measures examined did not differ between individuals in hospice with and without dementia. Use of tube feeding in hospice care and methods of pain assessment and treatment in individuals with dementia should be considered as potential quality-of-care measures.

    Original languageEnglish (US)
    Pages (from-to)1060-1065
    Number of pages6
    JournalJournal of the American Geriatrics Society
    Volume61
    Issue number7
    DOIs
    StatePublished - Jul 2013

    Keywords

    • NHHCS
    • dementia
    • hospice and palliative medicine
    • quality of care

    ASJC Scopus subject areas

    • Geriatrics and Gerontology

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  • Cite this

    Albrecht, J. S., Gruber-Baldini, A. L., Fromme, E. K., McGregor, J. C., Lee, D. S. H., & Furuno, J. P. (2013). Quality of hospice care for individuals with dementia. Journal of the American Geriatrics Society, 61(7), 1060-1065. https://doi.org/10.1111/jgs.12316