Patterns of Unmet Needs With Assistance for Self-Care Activities at the End of Life by Place of Death Among Older Adults

Abstract

Older Americans experience adverse consequences linked to inadequate assistance with self-care activities. These unmet care needs increase risk of hospitalization, institutionalization, and morbidity. While a growing body of research has focused on disparities in unmet care needs and place of death outcomes among older adults separately, less is known about the intersection between the two: place of death and unmet care needs at the end of life. Therefore, this study utilized data from the National Health & Aging Trends Study (NHATS) to examine patterns of place of death and unmet care needs outcomes among older adults to identify disparities in care and inform policies and programs. We conducted weighted bivariate analyses and multivariate logistic regression models using appropriate survey weights. Findings suggest more than half of older adults experienced an unmet need at the end of their lives and increasing rates of unmet needs are experienced by older adults who died in hospitals. Older adults receiving hospice care were also found to have less unmet needs at the end of their lives. Given the well-documented consequences of unmet needs with self-care activities, ongoing research is needed to better inform policies and programs that provide assistance and support to older adults with their self-care activities during their end of lives.