title: Does hospice improve quality of care for persons dying from dementia?
abstract: OBJECTIVE
  To examine the effectiveness of hospice services for persons dying from dementia from the perspective of bereaved family members.
  
  
  METHODS
  Mortality follow-back survey.
  
  
  METHODS
  Death certificates were drawn from five states (AL, FL, TX, MA, and MN).
  
  
  METHODS
  Bereaved family members listed as the next of kin on death certificates when dementia was listed as the cause of death.
  
  
  METHODS
  Ratings of the quality of end-of-life care, perceptions of unmet needs, and opportunities to improve end-of-life care. Two questions were also asked about the peacefulness of dying and quality of dying.
  
  
  RESULTS
  Of 538 respondents, 260 (48.3%) received hospice services. Family members of decedents who received hospice services reported fewer unmet needs and concerns with quality of care (adjusted odds ratio (AOR)=0.49, 95% confidence interval (CI)=0.33-0.74) and a higher rating of the quality of care (AOR=2.0, 95% CI=1.53-2.72). They also noted better quality of dying than those without hospice services.
  
  
  CONCLUSIONS
  Bereaved family members of people with dementia who received hospice reported higher perceptions of the quality of care and quality of dying.
authors.affiliation: Department of Community Health, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA. Joan_Teno@brown.edu
authors.forename: Joan M
authors.initials: JM
authors.lastname: Teno
authors.forename: Pedro L
authors.initials: PL
authors.lastname: Gozalo
authors.forename: Ian C
authors.initials: IC
authors.lastname: Lee
authors.forename: Sylvia
authors.initials: S
authors.lastname: Kuo
authors.forename: Carol
authors.initials: C
authors.lastname: Spence
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Connor
authors.forename: David J
authors.initials: DJ
authors.lastname: Casarett
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000191:economics / Q000401:mortality* / Q000628:therapy*; D003258:Consumer Behavior; D003362:Cost-Benefit Analysis; D005260:Female; D006301:Health Services Needs and Demand / Q000191:economics; D006302:Health Services Research; D006707:Homes for the Aged / Q000191:economics; D017051:Hospice Care / Q000191:economics; D006801:Humans; D008297:Male; D006278:Medicare / Q000191:economics; D009735:Nursing Homes / Q000191:economics; D058996:Quality Improvement / Q000191:economics; D013727:Terminal Care / Q000191:economics; D014481:United States