Hospice Experiences Vary by Care Setting for Patients With Dementia

Patients with dementia experienced variations in hospice care across different settings including nursing homes (NHs), acute care hospitals (ACHs), and assisted living facilities (ALFs), which poses opportunities for improvement.

According to researchers, utilization of hospice care has steadily increased among patients with dementia. Study authors investigated differences across settings of hospice care and analyzed Consumer Assessment of Health care Providers and Systems (CAHPS) Hospice Survey data from caregiver respondents who had family members that received hospice care.

Data was collected from 96,845 caregiver respondents with family members who had a primary dementia diagnosis and died in 2017 or 2018 while receiving hospice care in 2829 hospice facilities. Quality measure scores were calculated overall and adjusted for mode of survey administration and differences in case mix, arranged by setting, and determined variability in hospice level scores among decedents with dementia.

According to study results, “Mean quality measure scores ranged from 69.0 (Getting Hospice Care Training) to 90.9 (Getting Emotional Support).”

There were significantly difference score measures across all included hospice settings—with caregivers consistently reporting poorer quality of care for their decedents in NHs, ACHs, and ALFs. Furthermore, hospice-level scores ranged between the 10th and 90th percentiles of hospice performance.

“There are important opportunities to improve hospice care for patients with dementia and their caregivers, particularly with respect to caregiver training, symptom management, and across all dimensions within the NH, ACH, and ALF settings,” concluded study authors. “Variability in care experiences across hospices, as well as long lengths of stay for those with dementia, highlight the importance of informed and timely hospice referral.”

Reference:
Parast L, Tolpadi AA, Teno J, Elliott MN, Price RA. Variation in hospice experiences by care setting for patients with dementia. J Am Med Dir Assoc. Published online April 14, 2022. doi:10.1016/j.jamda.2022.03.010