Association between elder self-neglect and hospice utilization in a community population

Xin Qi Dong, Melissa A. Simon

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Elder self-neglect is associated with substantial 1-year mortality. However, hospice utilization among those with self-neglect remain unclear. The objective of this study is to quantify the prospective relation between self-neglect and risk for hospice utilization in a community population of older adults. Prospective population-based study in a geographically defined community in Chicago of older adults who participated in the Chicago Health and Aging Project. Of the 8669 participants in the Chicago Health and Aging Project, a subset of 1438 participants was reported to social services agency for suspected elder self-neglect. Outcome of interest was the hospice utilization obtained from the Center for Medicare and Medicaid System. Cox proportional hazard models were used to assess independent association of self-neglect with risk of hospice utilization using time-varying covariate analyses. After adjusting for potential confounding factors, elders who self-neglect was associated with increased risk for hospice utilization (HR, 2.43, 95% CI, 2.10-2.81). Greater self-neglect severity (mild: (HR, 2.12 (1.61-2.79); moderate: (HR, 2.36 (1.95-2.84); severe: (HR, 4.66 (2.98-7.30)) were associated with increased risk for hospice utilization. Interaction term analyses suggest that the significant relationship between self-neglect and hospice utilization was not mediated through medical conditions, cognitive impairment and physical disability. Moreover, self-neglect was associated with shorter length of stay in hospice (PE, -0.27, SE, 0.12, p<0.02) and shorter time from hospice admission to death (PE, -0.32, SE, 0.13, p<0.01). Elder self-neglect was associated with increased risk of hospice use in this community population. Elder self-neglect is associated with shorter length of stay in hospice care and shorter time from hospice admission to death.

Original languageEnglish (US)
Pages (from-to)192-198
Number of pages7
JournalArchives of Gerontology and Geriatrics
Volume56
Issue number1
DOIs
StatePublished - Jan 2013
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Health(social science)
  • Aging
  • Gerontology
  • Geriatrics and Gerontology

Keywords

  • Elder self-neglect
  • Hospice services utilization
  • Population-based study

Fingerprint

Dive into the research topics of 'Association between elder self-neglect and hospice utilization in a community population'. Together they form a unique fingerprint.

Cite this