Table 1. Characteristics of Nursing Home Residents with Advanced Dementia and Their Healthcare Proxies and Bivariate Associations with Greater Satisfaction with End-of-Life Care (N = 148).
| Characteristic | Value | P-value | Parameter Estimate (95% Confidence Interval) |
|---|---|---|---|
| Resident | |||
| Demographic | |||
| Age, mean ± SD (range) | 85.0 ± 8.1 (60.0-103.0) | .25 | -0.05 (-0.13-0.037) |
| Female, % | 87.8 | .09 | 1.75 (-0.28-3.72) |
| Length of stay, days, mean ± SD (range) | 1,402.3 ± 1,294.1 (54.0-5,537.0) | .01 | 0.0006 (0.0001-0.001) |
| Lives in special care dementia unit, % | 52.7 | .005 | 1.91 (0.56-3.20) |
| Health status | |||
| Bedford Alzheimer’s Nursing Severity Subscale score, mean ± SD (range)* | 20.8 ± 2.7 (11.0-27.0) | .94 | -0.01 (-0.25-0.24) |
| Symptom Management at the End of Life in Dementia score, mean ± SD (range)† | 36.1 ± 8.1 (10.0-45.0) | .007 | 0.11 (0.03-0.19) |
| Test for Severe Impairment score >0, %‡ | 21.0 | .56 | 0.49 (-1.20-2.08) |
| Tube fed, % | 6.8 | .003 | -4.00 (-6.61-1.37) |
| Advance care planning | |||
| Do not hospitalize, % | 49.3 | .001 | 2.18 (0.87-3.48) |
| Living will, % | 12.8 | .09 | -1.71 (-3.72-0.28) |
| Healthcare proxy | |||
| Sociodemographic | |||
| Age, mean ± SD (range) | 59.1 ± 11.7 (32.0-92.0) | .18 | -0.04 (-0.10-0.02) |
| Female, % | 61.5 | .25 | -0.80 (-2.16-0.60) |
| White, % | 92.6 | .17 | 1.80 (-0.77-4.36) |
| Married/living with partner, % | 71.6 | .27 | 0.85 (-0.66-2.32) |
| Education >high school, % | 77.7 | .29 | 0.86 (-0.73-2.51) |
| English is primary language, % | 96.6 | .43 | 1.48 (-2.26-5.22) |
| Child of resident, % | 73.0 | .94 | -0.03 (-1.54-1.48) |
| Working full time, % | 46.0 | .41 | 0.56 (-0.77-1.92) |
| Years designated as proxy, mean ± SD (range) | 7.1 ± 5.4 (0.50-40.0) | .04 | 0.13 (0.01-0.26) |
| Visits resident >7 hours per week, % | 20.3 | .69 | -0.34 (-2.05-1.31) |
| Health status, mean ± SD (range) | |||
| Medical Outcomes Survey 12-Item Short Form§ | |||
| Physical component | 51.7 ± 9.2 (21.0-65.0) | .25 | 0.05 (-0.03-0.12) |
| Mental component | 51.4 ± 9.9 (10.3-67.1) | .06 | -0.06 (-0.01-0.13) |
| K6∥ | 2.5 ± 3.4 (10.0-45.0) | .53 | -0.07 (-0.27-0.12) |
| Advance care planning, % | |||
| Primary goal of care is comfort | 95.2 | .01 | 3.96 (0.83-7.08) |
| Feels resident has <6 months to live | 8.7 | .47 | 0.97 (-1.69-3.66) |
| Spent >15 minutes discussing advance directives with a care provider | 55.3 | <.001 | 2.35 (1.04-3.63) |
| Physician counseled about prognosis | 35.8 | .10 | 1.18 (-0.24-2.56) |
*
Possible score 7-28; higher scores indicate greater functional disability.
†
Possible score 0-45; higher scores indicate greater comfort.
‡
Possible score 0-24; lower scores indicate greater cognitive impairment.
§
Possible score 10-70; higher scores indicate greater physical and mental health.
∥
Depressive symptom scale, possible score 0-24; higher scores indicate more depressive symptoms.
SD = standard deviation.