JAMDA
Volume 11, Issue 1 , Pages 21-25, January 2010

Home Care in the Last Year of Life: Family Member Perceptions of Unmet Need Associated With Last Place of Care

  • Aman Nanda, MD

      Affiliations

    • Division of Geriatrics, Rhode Island Hospital, Brown Medical School, Providence, RI
    • Corresponding Author InformationAddress correspondence to Aman Nanda, MD, Division of Geriatrics, Rhode Island Hospital, APC-424, 593 Eddy Street, Providence, RI 02903.
    • ,
  • Meg Bourbonniere, PhD, RN

      Affiliations

    • Office of Professional Nursing, Dartmouth-Hitchcock Medical Center, Lebanon, NH
    • ,
  • Terri Wetle, PhD

      Affiliations

    • Center for Gerontology and Health Care Research, Brown University, Providence, RI
    • Department of Community Health, Alpert Medical School, Brown University, Providence, RI
    • ,
  • Joan Teno, MD, MS

      Affiliations

    • Center for Gerontology and Health Care Research, Brown University, Providence, RI
    • Department of Community Health, Alpert Medical School, Brown University, Providence, RI

published online 26 November 2009.

Objective

To examine the association of family members' perception about the adequacy of home health services at the last place of care before death.

Design

Retrospective cross-sectional study. Mortality follow-back survey by telephone interview.

Setting

Home health services.

Participants

Bereaved family members or knowledgeable informants of deceased persons in 22 states.

Measurements

Proxy perception of need of home health care during the last 12 months of decedent's life, whether the amount of care received was enough, and last place of care (ie, where the person spent at least 48 hours nearest to the time of death).

Results

Of the 1578 interviews, 622 informants reported that decedents needed home health care in the last year of life. Among decedents needing home health care, 144 informants reported that the home health services provided did not meet their needs. After adjusting for age, gender, insurance, education, race, cause of death, functional status, and place of residence, decedents reported as not receiving enough home health care were 1.8 (95% CI 1.1–2.9) times more likely to die in a nursing home.

Conclusion

The perception that home health services before death did not meet the decedent's needs may contribute to greater nursing home use.

Keywords: Home care, dying, quality of care, site of death

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

 The authors have no conflicts of interest regarding this article.

 Funding for this research was provided by the Robert Wood Johnson Foundation (Grant #037188). The opinions and findings in this manuscript are those of the authors and do not necessarily represent the views of Robert Wood Johnson Foundation. The Robert Wood Johnson Foundation did not have any role in the design, conduct or interpretation of the research or in the review, approval, or control of the manuscript.

PII: S1525-8610(09)00258-8

doi:10.1016/j.jamda.2009.07.011

JAMDA
Volume 11, Issue 1 , Pages 21-25, January 2010

Article Tools