Research Shows Location of Death Can Impact Quality & Care

BIRMINGHAM, Alabama (Feb. 1, 2021)–Where people die can affect the quality of their deaths and their families’ satisfaction with the end-of-life care they receive, according to a recent study published in the Journal of the American Geriatrics Society.

The study looked at Medicare beneficiaries who died after the age of 64. By analyzing data from the National Health and Aging Trends Study, the authors found that people with cognitive impairment were more likely to die at home, while those without were equally likely to die at home or in a hospital.

All individuals—no matter their state of dementia or other cognitive health—were more likely to die at home if they received hospice care.

“Our findings suggest that older adults’ preference for place of death should be a central component of advance care planning, and the receipt of hospice care may be a key to achieving that preference,” said lead author Natalie G. Regier of the Johns Hopkins University School of Nursing.

The study found that people with cognitive impairment who used the Medicare Hospice Benefit were 14.5 times more likely to die at home versus the hospital and 3.4 times more likely to die at home than in a nursing home.

Cognitively healthy people using the benefit were more than six times more likely to die at home than in a hospital, and more than twice as likely to die at home than a nursing home.

The investigators also collected data from 1,500 proxies for the deceased to determine satisfaction with end-of-life care, looking at interviews conducted by the National Health and Aging Trends Study about the last month of life.

The results “suggest that place of death is a quality of care indicator for these populations,” the report says. “These findings may inform (end of life care) planning and policy‐making and facilitate greater well‐being at end‐of‐life.”