Approximately 6.7 million Americans over age 65 have dementia. That number is projected to double by 2050. Nursing homes (NHs) care for a growing number of older adults living with and dying from dementia. It is estimated that half of NH residents have dementia and nearly 70% of people with advanced dementia die in a NH.
A study published in 2024 entitled “Dying with Dementia in Nursing Homes: A Population-based Study of Decedents and their Families” reported on the results of a population-based study involving 18,339 individuals over the age of 65 with dementia who died of natural causes in a Utah NH between 1998 and 2016 and their first-degree family (FDF) members. One in five NH decedents with dementia in Utah did not have any FDF members.
The study found that decedents without FDF had lower comorbidity burdens and health care utilization than their peers with FDF, “suggesting that they may have needed NH care because family members or other caregivers were not available to help them remain in the community despite their relatively favorable health status, which is consistent with recent research demonstrating the availability of family reduces the likelihood of community-dwelling older adults with dementia transitioning to a NH and dying outside of the home. Compared to decedents with FDF, those without FDF were more likely to be unmarried women or persons with lower levels of educational attainment, Hispanic/non-White, and living in a rural area at the time of death. Such social determinants of health play a key role in health and EOL [end-of-life] outcomes in the general population. The lack of available family combined with other higher-risk social determinants may result in fewer nursing home options, admissions to lower quality NHs with fewer resources and staffing, which in turn may exacerbate inequities in dementia care and outcomes. Differences in available family shown here between men and women at EOL are consistent with other studies in non-dementia populations. Targeting supportive dementia care interventions to these arguably isolated or otherwise vulnerable groups without available family may improve equity in care.”
The researchers reported the take-away from the study: “Demographic changes over the past few decades are substantially reducing the potential pool of available family caregivers to care for the growing population of older adults with dementia. A substantial body of literature suggests that having available family makes a difference in the care of persons with dementia. This population-based study advances the science of NH dementia care and EOL care by highlighting potential health disparities that exist between those residents with and without family. The dearth of research on this fast-growing group of NH residents with dementia who do not have family presents significant challenges for developing appropriate interventions and policies that can improve the quality of NH care and outcomes, as well as reduce known health disparities. These results call for further investigation into why NH residents with dementia and without family have lower rates of healthcare utilization to ensure the care they receive at EOL aligns with their wishes.”
If you or a loved one may have been injured (or worse) in a nursing home in the United States due to nursing home staff shortage, nursing home understaffing, nursing home pressure ulcer (nursing home bedsore), a nursing home infection, nursing home fall, nursing home aspiration, nursing home neglect, nursing home negligence, nursing home abuse, or the nursing home failing to properly care for a vulnerable adult, you should promptly find a nursing home injury lawyer who may investigate your nursing home malpractice claim for you and represent you or your loved one in a nursing home malpractice case, if appropriate.
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