Hospice Care in Assisted Living Facilities Versus at Home: Results of a Multisite Cohort Study

In the Journal of the American Geriatrics Society, Meredith Dougherty and colleagues, including David Casarett, compare residents of assisted living facilities receiving hospice with people receiving hospice care at home. The researchers conducted an electronic health record-based retrospective cohort study to compare the difference in the two groups’ length of stay in hospice, use of opioids for pain, and site of death. The authors find the assisted living population was more likely than the home hospice population to have a diagnosis of dementia (23.5% vs 4.7%) and enroll in hospice closer to death (median length of stay 24 vs 29 days). Assisted living residents were less likely to receive opioids for pain (18.1% vs 39.7%) and less likely to die in an inpatient hospice unit (9.3% vs 16.1%) or a hospital (1.3% vs 7.6%). A better understanding of these differences could allow hospices to develop guidelines for better coordination of end-of-life care for the assisted living population.