The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #67487

Kyusuk Chung, PhD, Division of Health Administration and Human Services, Governors State University, F Wing, College of Health Professions, Governors State University, University Park, IL 60466, (708)534-4047, k-chung@govst.edu, Duck-Hye Yang, PhD, Illinois Department of Human Services, 160 N. LaSalle Suite 100, Chicago, IL 60601-3103, and Sangho Moon, PhD, Institute of Government, Tennessee State University, 330 10th Ave. North, Nashiville, TN 37203.

As one of social determinants of a “good death”, we explored the role that caregivers may play for the dying elderly, using the 2000 National Home and Hospice Care Survey data by the National Center for Health Statistics. The survey defined a primary caregiver as an individual or organization that is responsible for providing personal care assistance, companionship, and/or supervision to the patient. We focused on the elderly (over 65) that died and placed their deaths into two classifications: the no-caregiver group (N=1,630) and the caregiver group (N=142). Then we compared the length of stay, referral source and diagnosis at admission and hospice care, using t-test or chi-square test. No difference was found in days of stay (median days=21 for both). The no-caregiver group were less likely to have physicians as referral source (37% vs 53%; p=<0.001) but more likely to have hospitals as referral source (25% vs 18%; p=0.09). The no-caregiver group were less likely to get hospice care (76% vs 92%; p=<0.001). Only 32% of the no-caregiver group who had hospice care died at home, compared to 68% of the caregiver group who had hospice care (p=<0.001). As many as 33% of the no-caregiver group who had hospice care died at inpatient-care units, compared to only11% of the caregiver group (p=<0.001). Finally, the no-caregiver group were more likely to die of chronic and ambulatory care sensitive conditions (defined here as asthma, chronic obstructive pulmonary disease, congestive health failure, seizure disorder, and diabetes mellitus) (10% vs 19%; p=0.002).

Learning Objectives:

• Assess the importance of the presence of caregivers for the terminally-ill elderly.
• Identify the impact of having caregivers on continuity of care, end-of-life care and good death for the dying elderly.

Keywords: Elderly, End-of-Life Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.