scholarly journals Family caregiving and place of death: Insights from cross-national analysis of the Harmonized End of Life Data

2020 ◽  
Author(s):  
Jennifer Ailshire ◽  
Margarita Osuna ◽  
Jenny Wilkens ◽  
Jinkook Lee
Keyword(s):  
United States ◽  
Older Adults ◽  
Nursing Home ◽  
End Of Life ◽  
Family Caregiving ◽  
The United States ◽  
Place Of Death ◽  
Life Data ◽  
Cross National ◽  
At Home

Abstract Objectives Family is largely overlooked in research on factors associated with place of death among older adults. We determine if family caregiving at the end of life is associated with place of death in the United States and Europe. Methods We use the Harmonized End of Life data sets developed by the Gateway to Global Aging Data for the Survey of Health, Ageing and Retirement in Europe (SHARE) and the Health and Retirement Study (HRS). We conducted multinomial logistic regression on 7,113 decedents from 18 European countries and 3,031 decedents from the United States to determine if family caregiving, defined based on assistance with activities of daily living, was associated with death at home versus at a hospital or nursing home. Results Family caregiving was associated with reduced odds of dying in a hospital and nursing home, relative to dying at home in both the United States and Europe. Care from a spouse/partner or child/grandchild was both more common and more strongly associated with place of death than care from other relatives. Associations between family caregiving and place of death were generally consistent across European welfare regimes. Discussion This cross-national examination of family caregiving indicates that family-based support is universally important in determining where older adults die. In both the United States and in Europe, most care provided during a long-term illness or disability is provided by family caregivers, and it is clear families exert tremendous influence on place of death.

Improving psychotropic medication use among persons with dementia

2016 ◽  
Vol 28 (10) ◽  
pp. 1587-1588 ◽  
Author(s):  
Donovan T. Maust
Keyword(s):  
United States ◽  
Older Adults ◽  
Nursing Home ◽  
Psychotropic Medication ◽  
Medication Use ◽  
The United States ◽  
Black Box ◽  
Community Settings ◽  
Limited Evidence

The use of psychotropic medication among persons with dementia (PWD) both in nursing home (Wetzels et al., 2011) and community settings (Maust et al., 2016) far exceeds what might be expected based on their limited evidence for benefit (Kales et al., 2015). This relatively high use persists despite years of evidence about the potential harms associated with their use in older adults generally and PWD in particular (e.g. Wang et al., 2001; Schneider et al., 2005). However, the solution to relatively high psychotropic use is not to end all psychotropic use, as there are individual patients for whom use of such medication is appropriate. For example, a policy that defines all antipsychotic use as inappropriate may simply lead to increased use of alternatives with even less evidence of benefit, as suggested by the response to antipsychotics’ black box warning in the United States (Kales et al., 2011).

Family Caregiving

2013 ◽  
Author(s):  
Sandra Owens ◽  
Letha A. Chadiha
Keyword(s):  
United States ◽  
Older Adults ◽  
Family Caregiving ◽  
The United States ◽  
Evidence Based ◽  
Socioeconomic Impacts ◽  
Scholarly Literature ◽  
Societal Issues

There is evidence that family caregiving in the United States has been increasing at an unprecedented rate as a result of various societal issues. This entry provides a summary of the scholarly literature regarding elder-caregiving trends, demographics, legislation, challenges, and racial and socioeconomic impacts, as well as the rewards of caregiving. Additionally, the entry provides empirical findings regarding evidence-based interventions associated with family caregiving of older adults.

scholarly journals A Descriptive Analysis of Location of Older Adult Falls That Resulted in Emergency Department Visits in the United States, 2015

2020 ◽  
pp. 155982762094218
Author(s):  
Briana L. Moreland ◽  
Ramakrishna Kakara ◽  
Yara K. Haddad ◽  
Iju Shakya ◽  
Gwen Bergen
Keyword(s):  
United States ◽  
Older Adults ◽  
Emergency Department ◽  
The United States ◽  
Emergency Department Visits ◽  
Targeted Prevention ◽  
Injury Surveillance System ◽  
Injurious Falls ◽  
Ed Visits ◽  
At Home

Introduction. Falls among older adults (age ≥65) are a common and costly health issue. Knowing where falls occur and whether this location differs by sex and age can inform prevention strategies. Objective. To determine where injurious falls that result in emergency department (ED) visits commonly occur among older adults in the United States, and whether these locations differ by sex and age. Methods. Using 2015 National Electronic Injury Surveillance System-All Injury Program data we reviewed narratives for ED patients aged ≥65 who had an unintentional fall as the primary cause of injury. Results. More fall-related ED visits (71.6%) resulted from falls that occurred indoors. A higher percentage of men’s falls occurred outside (38.3%) compared to women’s (28.4%). More fall-related ED visits were due to falls at home (79.2%) compared to falls not at home (20.8%). The most common locations for a fall at home were the bedroom, bathroom, and stairs. Conclusion. The majority of falls resulting in ED visits among older adults occurred indoors and varied by sex and age. Knowing common locations of injurious falls can help older adults and caregivers prioritize home modifications. Understanding sex and age differences related to fall location can be used to develop targeted prevention messages.

scholarly journals TRENDS AND FACTORS ASSOCIATED WITH PLACE OF DEATH AMONG INDIVIDUALS WITH CARDIOVASCULAR DISEASE IN THE UNITED STATES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S132-S133 ◽  
Author(s):  
Sarah H Cross ◽  
Brystana G Kaufman ◽  
Haider Warraich
Keyword(s):  
United States ◽  
Cardiovascular Disease ◽  
Heart Disease ◽  
College Education ◽  
Hypertensive Heart Disease ◽  
The United States ◽  
Place Of Death ◽  
Home Death ◽  
Factors Associated ◽  
At Home

Abstract While most patients prefer to die at home, trends and factors associated with place of death for patients dying of cardiovascular disease (CVD) remain unknown. Using data from the National Center for Health Statistics from 2003-2017, we described trends and conducted multivariable logistic regression to evaluate associations between demographic characteristics and place of death among CVD patients in the United States. From 2003-2017, the rate of CVD deaths occurring at home increased from 21.3% to 30.9%, and rate of hospice facility deaths increased from practically none to 6.0%. Over the same period, the rate of hospital deaths decreased from 36.5% to 27.3%, and nursing facility deaths decreased from 25.1% to 20.6%. With the exception of conduction disorders, temporal trends in place of death were consistent across CVD diagnosis subgroups: ischemic heart disease, hypertensive heart disease, heart failure/cardiomyopathy, cerebrovascular disease, aortic stenosis, and all other CVDs. Differences between demographic groups persisted over the study period, with reduced odds of home death among Hispanic versus non-Hispanic (OR=.942; 95% CI .929-.955) decedents, Black versus White (OR=.837; CI .809-.866) decedents and greater odds of home death among decedents with some college education or more (OR=1.08; CI 1.06-1.09) versus decedents with a high-school education or less. In 2014, home surpassed hospital as the most common place of death for CVD patients. CVD patients often have acute and intense needs at the end of life that are challenging to manage in the home and the quality of care these patients receive should be further investigated.

The experience of worry among young and older adults in the United States and Germany: A cross-national comparison

2012 ◽  
Vol 16 (4) ◽  
pp. 413-422 ◽  
Author(s):  
Renée L. Babcock ◽  
Eileen E. MaloneBeach ◽  
Beini Hou ◽  
Melinda Smith
Keyword(s):  
United States ◽  
Older Adults ◽  
The United States ◽  
National Comparison ◽  
Cross National

scholarly journals Caregiving, Recovery, and Death After Incident ADL/IADL Disability Among Older Adults in the United States

2019 ◽  
Vol 39 (4) ◽  
pp. 393-397 ◽  
Author(s):  
Claire K. Ankuda ◽  
Deborah A. Levine ◽  
Kenneth M. Langa ◽  
Katherine A. Ornstein ◽  
Amy S. Kelley
Keyword(s):  
United States ◽  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Functional Disability ◽  
The United States ◽  
Levels Of Care ◽  
Iadl Disability ◽  
And Function ◽  
At Home

This study assesses patterns of caregiving, death, and recovery after incident disability in older adults. We used the Health and Retirement Study to follow of a cohort of adults age ≥65 years in the United States with incident disability in activities of daily living (ADLs) or instrumental activities of daily living (IADLs; n = 8,713). Rates of care and function state were assessed biennially: deceased, nursing home dwelling, at home with paid help, at home with both paid and unpaid help, at home with unpaid help, at home with no assistance and recovered. In the 2 years after incident disability, 22.1% recovered and 46.8% died. Transitions between care and function states occurred frequently, with more than 20% of the cohort living at home with no assistance despite disability at least once. This study demonstrates the high levels of care and function state fluctuation and unmet needs after functional disability.

scholarly journals Cross-national insights into the relationship between wealth and wellbeing: a comparison between Australia, the United States of America and South Korea

2011 ◽  
Vol 32 (1) ◽  
pp. 41-59 ◽  
Author(s):  
SARANG KIM ◽  
KERRY A. SARGENT-COX ◽  
DAVINA J. FRENCH ◽  
HAL KENDIG ◽  
KAARIN J. ANSTEY
Keyword(s):  
United States ◽  
Older Adults ◽  
Life Satisfaction ◽  
United States Of America ◽  
The United States ◽  
National Study ◽  
Additional Contribution ◽  
Self Rated Health ◽  
The Relationship ◽  
Cross National

ABSTRACTThe positive relationship between wealth and wellbeing has received considerable attention over the last three decades. However, little is known about how the significance of wealth for the health and wellbeing of older adults may vary across societies. Furthermore, researchers tend to focus mainly on income rather than other aspects of financial resources even though older adults often rely on fixed income, particularly after retirement. Using data from the Household, Income and Labour Dynamics in Australia (HILDA) survey (N=1,431), the Health and Retirement Study (HRS) in the United States of America (USA; N=4,687), and the Korean Longitudinal Study of Ageing (KLoSA; N=5,447), this exploratory cross-national study examined the relationship between wealth satisfaction and objective wealth and wellbeing (measured as self-rated health and life satisfaction) among older Australians, Americans and Koreans (50+ years). Regression analyses showed that wealth satisfaction was associated with wellbeing over and above monetary wealth in all three countries. The relationship between monetary wealth and self-rated health was larger for the US than Australian and Korean samples, while the additional contribution of wealth satisfaction to life satisfaction was larger for the Korean than the Australian and US samples. These findings are discussed in terms of the cultural and economic differences between these countries, particularly as they affect older persons.

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