ArticleJournal of the American Geriatrics Society2020
Family Caregiving at the End of Life and Hospice Use: A National Study of Medicare Beneficiaries.
Article in Journal of the American Geriatrics Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 3 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Experiences of death preparedness among family caregivers of terminal patients: a systematic review and meta-synthesis.Frontiers in public health · 2026Pooled it
- Caregiver-reported barriers and facilitators to hospice enrollment for persons with dementia: A systematic review of qualitative evidence.Palliative medicine · 2025Pooled it
- Factors influencing accessibility of palliative care: a systematic review and meta-analysis.BMC palliative care · 2025Pooled it
- When Is the Best Time to Deliver Supportive Interventions to Hospice Family Caregivers? A Multi-Method Study.The Gerontologist · 2025Trial
- Insomnia Symptoms Among Hospice Family Caregivers: Prevalence and Association with Caregiver Mental and Physical Health, Quality of Life, and Caregiver Burden.The American journal of hospice & palliative care · 2023Trial
- Caregiver Availability and Racial Differences in End-Of-Life Care Quality: Evidence From the National Health and Aging Trends Study 2017-2024.Journal of the American Geriatrics Society · 2026Article
- The Impact of Dementia Caregiving on the Health of the Spousal Caregiver.Medicina (Kaunas, Lithuania) · 2026Review
- Differences in patient access to and utilization of caregiving services: a scoping review.BMC health services research · 2026Article
- Kinlessness and end-of-life care quality: does race and ethnicity matter?The journals of gerontology. Series B, Psychological sciences and social sciences · 2025Article
- End-of-life issues in older adults: Emotional and social factors that shape end-of-life experiences.Advances in psychiatry and behavioral health · 2025Article
- Economic Value of Unpaid Family Caregiver Time Following Hospital Discharge and at End of Life.Journal of pain and symptom management · 2024Article
- Navigating a "Good Death" During COVID-19: Understanding Real-Time End-of-Life Care Structures, Processes, and Outcomes Through Clinical Notes.The Gerontologist · 2024Article
- The Medicare Care Choices Model was associated with reductions in disparities in the use of hospice care for Medicare beneficiaries with terminal illness.Health services research · 2024Article
- 2024 Alzheimer's disease facts and figures.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
- Clinician Perception of Likelihood of Death in the Next Year Is Associated With 1-Year Mortality and Hospice Use Among Older Adults Receiving Home Health Care.Journal of palliative medicine · 2024Article
- Knowledge Gaps in End-Of-Life Family Caregiving for Persons Living With Dementia: A Study of Hospice Clinician Perspectives.The American journal of hospice & palliative care · 2024Article
- Dementia caregiver burdens predict overnight hospitalization and hospice utilization.Palliative & supportive care · 2023Article
- End-of-Life Experiences Among "Kinless" Older Adults: A Nationwide Register-Based Study.Journal of palliative medicine · 2023Article
- Quality of End-of-Life Care for Older Adults with Dementia during the COVID-19 Pandemic.Journal of the American Medical Directors Association · 2023Article
- Pathways to healing: Plants with therapeutic potential for neurodegenerative diseases.IBRO neuroscience reports · 2023Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
BACKGROUND/
objectivesHospice care confers well-documented benefits to patients and their families, but it is underutilized. One potential reason is inadequate family support to make end-of-life decisions and care for older adults on hospice at home. We assessed the association between amount of family support and hospice use among a population of decedents and among specific illness types.
designProspective cohort study using the National Health and Aging Trends Study waves 2011 to 2017, linked to Medicare claims data.
settingContiguous United States.
participantsA total of 1,868 NHATS decedents. MEASUREMENTS: Outcome variable was 1 day or longer of hospice. Family caregiving intensity was measured by self-reported hours of care per week and number of caregivers. Covariates included probable dementia status and other demographic, clinical, and functional characteristics.
resultsAt the end of life, hours of family caregiving and numbers of helpers vary widely with individuals with dementia receiving the most hours of unpaid care (mean = 64.5 hours per week) and having 2.4 unpaid caregivers on average. In an adjusted analysis, older adults with cancer receiving 40 hours and more of unpaid care/week as compared with fewer than 6 hours per week were twice as likely to receive hospice care at the end of life (odds ratio = 2.0; 95% confidence interval = 1.0-4.1). This association was not seen among those with dementia or among decedents in general. No significant association was found between number of caregivers and hospice use at the end of life.
conclusionOlder adults at the end of life receive a high number of hours of help at the end of life, many from more than one caregiver, which may shape hospice access. Better understanding of disparities in hospice use can facilitate timely access to care for older adults with a serious illness. J Am Geriatr Soc 68:2288-2296, 2020.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.