ArticleJournal of the American Geriatrics Society2021
Survival in hospice patients with dementia: the effect of home hospice and nurse visits.
Article in Journal of the American Geriatrics Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 5 of them syntheses that pooled it.
What it found
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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
25 citing papers in PubMed, 5 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Caregiver-reported barriers and facilitators to hospice enrollment for persons with dementia: A systematic review of qualitative evidence.Palliative medicine · 2025Pooled it
- Live Hospice Discharge of Individuals with Cognitive Disabilities: A Systematic Review.Journal of the American Medical Directors Association · 2025Pooled it
- Live Discharge of Hospice Patients with Alzheimer's Disease and Related Dementias: A Systematic Review.The American journal of hospice & palliative care · 2024Pooled it
- Hospice interventions for persons living with dementia, family members and clinicians: A systematic review.Journal of the American Geriatrics Society · 2022Pooled it
- Nurses' Experience of Nursing Workload-Related Issues during Caring Patients with Dementia: A Qualitative Meta-Synthesis.International journal of environmental research and public health · 2021Pooled it
- Closing the hospice gap: the value of home-based medical care.Health affairs scholar · 2026Article
- Benzodiazepine or Antipsychotic Use and Mortality Risk Among Patients With Dementia in Hospice Care.JAMA network open · 2025Article
- Developing and Testing a Two-Part Intervention: Enhancing Dementia Instruction and Tool in Home Hospice Care.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2025Article
- Improving Policy and Practices of Hospice Live Discharge: A Historical Exploration of the Medicare Hospice Benefit.Journal of aging & social policy · 2025Article
- Lung Cancer and Palliative Care Support: The Role of Social Determinants of Health for Older Adult Patients.Oncology nursing forum · 2024Article
- Market segmentation by profit status: evidence from hospice.Health affairs scholar · 2024Article
- End-of-Life Health Care Service Use and Cost Among Medicare Decedents With Neurodegenerative Diseases.Neurology · 2024Article
- Hospice Readmission, Hospitalization, and Hospital Death Among Patients Discharged Alive from Hospice.JAMA network open · 2024Article
- Article
- Dementia caregiver burdens predict overnight hospitalization and hospice utilization.Palliative & supportive care · 2023Article
- The Lysine Demethylase KDM7A Regulates Immediate Early Genes in Neurons.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2023Article
- Healthcare Utilization and Mortality After Hospice Live Discharge Among Medicare Patients With and Without Alzheimer's Disease and Related Dementias.Journal of general internal medicine · 2023Article
- Hospice Composition Based on Diagnosis is Associated with Caregiver-Reported Quality Measures.The American journal of hospice & palliative care · 2022Article
- Variation in Benzodiazepine and Antipsychotic Prescribing Among Hospice Agencies.Journal of general internal medicine · 2022Article
- Associations between dementia diagnosis and end-of-life care utilization.Journal of the American Geriatrics Society · 2022Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundHospice patients with dementia are at increased risk for live discharge and long lengths of stay (>180 days), causing patient and family caregiver stress and burden. The location and timing of clinician visits are important factors influencing whether someone dies as expected, in hospice, or experiences a live discharge or long length of stay.
objectiveExamine how home hospice and nurse visit frequency relate to dying in hospice within the Medicare-intended 6-month period.
designRetrospective cohort study.
settingNon-profit hospice agency.
participantsThree thousand eight hundred and thirty seven patients with dementia who received hospice services from 2013 to 2017.
methodsMultivariable survival analyses examined the effects of receiving home hospice (vs. nursing home) and timing of nurse visits on death within 6 months of hospice enrollment, compared to live discharge or long length of stay. Models adjust for relevant demographic and clinical factors.
resultsThirty-nine percent (39%) of patients experienced live discharge or long length of stay. Home hospice patients were more likely to experience live discharge or long length of stays (HR for death: 0.77, 95%CI: 0.69-0.86, p < 0.001). Frequency of nurse visits was inversely associated with live discharge and long lengths of stay (HR for death: 2.87, 95%CI: 2.47-3.33, p < 0.001).
conclusionNearly 40% of patients with dementia in our study experienced live discharge or a long length of stay. Additional research is needed to understand why home hospice may result in live discharge or a long length of stay for patients with dementia. Nurse visits were associated with death, suggesting their responsiveness to deteriorating patient health. Hospice guidelines may need to permit longer stays so community-dwelling patients with dementia, a growing segment of hospice patients, can remain continuously enrolled in hospice and avoid burden and costs associated with live discharge.
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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.