Exhibit 2:
Outcomes of last-month-of-life care quality, overall and comparing people living with dementia and those without dementia among Medicare beneficiaries ages 70 and older by dementia status, 2011–17
| Measure | Overall | Without dementia | With dementia | P-valuea |
|---|---|---|---|---|
| Quality of care (no.) | 1,987b | 1,051 | 936 | 0.832 |
| Excellent (%) | 48.3 | 48.5 | 48.0 | |
| Very good to poor (%) | 51.7 | 51.5 | 52.0 | |
| Pain (no.) | 1,857 | 1,012 | 845 | 0.0527 |
| No pain (%) | 30.3 | 30.8 | 29.4 | |
| Pain not managed (%) | 16.0 | 17.8 | 13.2 | |
| Pain managed (%) | 53.8 | 51.4 | 57.3 | |
| Trouble breathing (no.) | 1,901 | 1,033 | 868 | 0.054 |
| No trouble breathing | 44.0 | 42.0 | 46.8 | |
| Breathing not managed (%) | 11.1 | 12.6 | 8.9 | |
| Breathing managed (%) | 44.9 | 45.3 | 44.3 | |
| Anxiety or sadness (no.) | 1,782 | 988 | 794 | 0.0903 |
| No anxiety (%) | 41.7 | 43.2 | 39.5 | |
| Anxiety not managed (%) | 27.1 | 27.7 | 26.2 | |
| Anxiety managed (%) | 31.1 | 29.1 | 34.3 | |
| Personal care managed (no.) | 1,973 | 1,036 | 937 | 0.0173 |
| Always (%) | 81.0 | 79.0 | 83.7 | |
| Usually to never (%) | 19.0 | 21.0 | 16.3 | |
| Enough spiritual support (no.) | 1,543 | 806 | 737 | 0.714 |
| No (%) | 57 | 56.5 | 57.6 | |
| Yes (%) | 43 | 43.5 | 42.4 | |
| Goal-consistent care (no.) | 1,936 | 1,026 | 910 | 0.2786 |
| No (%) | 11.7 | 11.0 | 12.8 | |
| Yes (%) | 88.3 | 89.1 | 87.3 | |
| Treated with respect (no.) | 1,972 | 1,033 | 939 | 0.717 |
| Always (%) | 87.2 | 87.3 | 87.0 | |
| Usually to never (%) | 12.8 | 12.7 | 13.0 | |
| Patient or family input (no.) | 1,934 | 1,024 | 910 | 0.4052 |
| No (%) | 9.3 | 9.8 | 8.5 | |
| Yes (%) | 90.7 | 90.2 | 91.5 | |
| Family informed (no.) | 1,973 | 1,040 | 933 | 0.032 |
| Always (%) | 80.6 | 78.9 | 83.1 | |
| Usually to never (%) | 19.4 | 21.2 | 16.9 | |
| Care coordinated (no.) | 1,879 | 986 | 893 | <0.001 |
| No (%) | 13.4 | 16.9 | 8.6 | |
| Yes (%) | 86.6 | 83.1 | 91.4 | |
| Late transitionc (no.) | 1,957 | 1,056 | 901 | 0.0197 |
| No (%) | 81.5 | 79.7 | 84.2 | |
| Yes (%) | 18.5 | 20.3 | 15.8 |
SOURCE Authors’ analysis of the data from participants in the National Health and Aging Trends Study ages 70 and older who had a sample person interview and who died between 2011 and 2017. Outcome measures are presented as weighted numbers and percents and are drawn from the last-month-of-life survey were completed by a proxy (71 percent of respondents were spouses or children); mean time to completion after decedent death was approximately 6 months (mean: 188.5 days; standard deviation: 131.6 days). For a table that includes additional data, see online appendix exhibit A9 (see note 31 in text).
P values are the result of unadjusted bivariate analyses including chi-square tests for categorical variables to determine statistically significant differences between those with and without dementia.
As response rates varied by outcome, the first row of each outcome includes the N for each population.
Late transitions were defined as care setting changes in the last 3 days of life.