Mortality Risk Following End-of-Life Caregiving: A Population-Based Analysis of Hospice Users and Their Families (GP135)

Outcomes 1. Explain how hospice experiences might have implications for the surviving family's health.2. Explain how gender and other contexts can modify the family's hospice experience. Key Message Hospice experiences might increase mortality risk for surviving family. Longer hospice stays and being the only nearby family member are risk factors, depending upon gender and relationship type. Having more family members is protective against survivors’ mortality risk, but dementia in hospice is particularly risky for a surviving widow's health. Importance Hospice has implications for not only the patient but their surviving family. This research might help identify at-risk family members for targeted interventions. Objective(s) This study uses familial-linked administrative records from the Utah Population Database to assess how variations in family hospice experiences affect mortality risk for surviving spouses and children. Scientific Methods Utilized From a population database, we studied a cohort of hospice decedents living in Utah between 1998 and 2016 linked to their spouses and adult children (n=37,271 pairs). Linking medical records, vital statistics, and other administrative microdata to describe decedent-kin pairs, event-history models assessed how hospice duration and characteristic of the family, including familial network size and coresidence with the decedent, were associated with long-term mortality risk of surviving family members. Results Longer hospice duration increased mortality risk for daughters and husbands, but not sons or wives. Having other family members in the state was protective, and living in the same household as the decedent prior to death was a risk factor for sons. Conclusion(s) We conclude that relationship type and sex modify the how of end-of-life stressors (i.e., potential caregiving demands and bereavement experiences) affect health because of normative gender roles. Furthermore, exposure to dementia deaths may be particularly stressful, especially for females. Impact Using a large population database, we assess mortality risk not only for spouses of hospice decedents, but also for their children. We are aware of no other research systematically exploring this topic using large datasets.