Hospice care lengthier in assisted living compared with skilled nursing, homes

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Kathleen Unroe, M.D., MHA
Kathleen Unroe, M.D., MHA

Median length of hospice care for assisted living residents is more than twice as long as it is for skilled nursing residents or people receiving care in traditional homes, according to a new study published online ahead of print in the Journal of the American Geriatrics Society.

Assisted living residents in the study had a median of 42 days of hospice care compared with 19 days for nursing home residents and 17 days for people living at home, found researchers from the Indiana University Center for Aging Research and the Regenstrief Institute. They attributed the difference to the fact that the assisted living residents receiving hospice care were older and more likely to have dementia as their terminal diagnosis than were the nursing home residents or hospice patients living at home.

The investigators analyzed data from more than 32,600 men and women in 18 states who received routine hospice care from 2009 to 2015. Approximately 43% had hospice stays of less than two weeks, whereas 20% had hospice care for more than six months.

They also found that assisted living and nursing home residents receiving hospice care were more likely to be cared for by aides, whereas people receiving hospice care at home were more likely to be cared for by nurses.

Lead researcher Kathleen Unroe, M.D., MHA, said the difference may be explained in part by differences in diagnoses.

“A patient with a lot of medical complexity who is living at home requires more nurse visits,” she said. “Individuals with advanced dementia who live in assisted living facilities or nursing homes may require more hospice aide assistance to keep them comfortable in the terminal phase of that disease.”

Minimal differences were found in the intensity of hospice services provided at the various sites, however.

“It has been a concern that patients who live in nursing homes or assisted living facilities may be getting potentially less hospice care than people receiving hospice care at home,” Unroe said. “We found that not to be the case.”

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