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Does Hospice Improve Quality of Care for Persons Dying from Dementia?


Address correspondence to Joan M. Teno, 121 South Main Street, Providence, RI 02912. E-mail:


OBJECTIVES: To examine the effectiveness of hospice services for persons dying from dementia from the perspective of bereaved family members.

DESIGN: Mortality follow-back survey.

SETTING: Death certificates were drawn from five states (AL, FL, TX, MA, and MN).

PARTICIPANTS: Bereaved family members listed as the next of kin on death certificates when dementia was listed as the cause of death.

MEASUREMENTS: Ratings of the quality of end-of-life care, perceptions of unmet needs, and opportunities to improve end-of-life care. Two questions were also asked about the peacefulness of dying and quality of dying.

RESULTS: Of 538 respondents, 260 (48.3%) received hospice services. Family members of decedents who received hospice services reported fewer unmet needs and concerns with quality of care (adjusted odds ratio (AOR)=0.49, 95% confidence interval (CI)=0.33–0.74) and a higher rating of the quality of care (AOR=2.0, 95% CI=1.53–2.72). They also noted better quality of dying than those without hospice services.

CONCLUSION: Bereaved family members of people with dementia who received hospice reported higher perceptions of the quality of care and quality of dying.