Skip to main content
Journal cover image

End-of-life care in nursing home settings: do race or age matter?

Publication ,  Journal Article
Reynolds, KS; Hanson, LC; Henderson, M; Steinhauser, KE
Published in: Palliat Support Care
March 2008

OBJECTIVE: One-quarter of all U.S. chronic-disease deaths occur in nursing homes, yet few studies examine palliative care quality in these settings. This study tests whether racial and/or age-based differences in end-of-life care exist in these institutional settings. METHODS: We abstracted residents' charts (N = 1133) in 12 nursing homes. Researchers collected data on indicators of palliative care in two domains of care--advance care planning and pain management--and on residents' demographic and health status variables. Analyses tested for differences by race and age. RESULTS: White residents were more likely than minorities to have DNR orders (69.5% vs. 37.3%), living wills (39% vs. 5%), and health care proxies (36.2% vs. 11.8%; p < .001 for each). Advance directives were highly and positively correlated with age. In-depth advance care planning discussions between residents, families, and health care providers were rare for all residents, irrespective of demographic characteristics. Nursing staff considered older residents to have milder and less frequent pain than younger residents. We found no disparities in pain management based on race. SIGNIFICANCE OF RESULTS: To the extent that advance care planning improves care at the end of life, racial minorities in nursing homes are disadvantaged compared to their white fellow residents. Focusing on in-depth discussions of values and goals of care can improve palliative care for all residents and may help to ameliorate racial disparities in end-of-life care. Staff should consider residents of all ages as appropriate recipients of advance care planning efforts and should be cognizant of the fact that individuals of all ages can experience pain. Nursing homes may do a better job than other health care institutions in eliminating racial disparities in pain management.

Duke Scholars

Published In

Palliat Support Care

DOI

ISSN

1478-9515

Publication Date

March 2008

Volume

6

Issue

1

Start / End Page

21 / 27

Location

England

Related Subject Headings

  • White People
  • Palliative Care
  • Pain Management
  • Oncology & Carcinogenesis
  • Nursing Homes
  • North Carolina
  • Minority Groups
  • Middle Aged
  • Male
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Reynolds, K. S., Hanson, L. C., Henderson, M., & Steinhauser, K. E. (2008). End-of-life care in nursing home settings: do race or age matter? Palliat Support Care, 6(1), 21–27. https://doi.org/10.1017/S1478951508000047
Reynolds, Kimberly S., Laura C. Hanson, Martha Henderson, and Karen E. Steinhauser. “End-of-life care in nursing home settings: do race or age matter?Palliat Support Care 6, no. 1 (March 2008): 21–27. https://doi.org/10.1017/S1478951508000047.
Reynolds KS, Hanson LC, Henderson M, Steinhauser KE. End-of-life care in nursing home settings: do race or age matter? Palliat Support Care. 2008 Mar;6(1):21–7.
Reynolds, Kimberly S., et al. “End-of-life care in nursing home settings: do race or age matter?Palliat Support Care, vol. 6, no. 1, Mar. 2008, pp. 21–27. Pubmed, doi:10.1017/S1478951508000047.
Reynolds KS, Hanson LC, Henderson M, Steinhauser KE. End-of-life care in nursing home settings: do race or age matter? Palliat Support Care. 2008 Mar;6(1):21–27.
Journal cover image

Published In

Palliat Support Care

DOI

ISSN

1478-9515

Publication Date

March 2008

Volume

6

Issue

1

Start / End Page

21 / 27

Location

England

Related Subject Headings

  • White People
  • Palliative Care
  • Pain Management
  • Oncology & Carcinogenesis
  • Nursing Homes
  • North Carolina
  • Minority Groups
  • Middle Aged
  • Male
  • Humans