For persons with dementia (PWD), who may be particularly vulnerable to getting care at the end of life that is not consistent with their wishes or that causes a greater strain on caregivers, less was known regarding racial inequalities in sites of death. For a study, researchers sought to ascertain whether there were racial and ethnic variations in the PWD population’s places of death.
Data from the statewide-representative National Health and Aging Trends survey was examined. Participants were accepted if they died between 2012 and 2020 and had probable dementia as determined by a previously established methodology. Self-reports of race and ethnicity were made. A post-mortem discussion with devastated caregivers revealed the place of death.
Among the 993 dementia patients in the sample, 81.4% were white, 11.0% were black, and 7.6% were Hispanic. Compared to white decedents (19.0%), more black and Hispanic decedents (30.3% and 32.8%, respectively) died in hospitals. When compared to black (22.4%) and Hispanic decedents (15.0%), the percentage of white nursing home deaths was greater (31.0%). In analyses that took into account adjustments, black decedents had a greater likelihood of dying in a hospital (AOR 1.50; 95% CI 1.01, 2.24) than white decedents, and similar tendencies were seen for Hispanic decedents.
The place of death for PWD varied by race and ethnicity, with black and Hispanic PWD more likely to pass away in a hospital than white PWD. More study is required to ascertain whether the disparities seen were due to goal-concordant treatment or rather a lack of access to high-quality care near the end of life.
Reference: jpsmjournal.com/article/S0885-3924(22)00720-5/fulltext
