Racial/Ethnic Disparities in Nursing Home End-of-Life Care: A Systematic Review.
Leah V Estrada, Mansi Agarwal, Patricia W Stone
PMID 33428892WHAT IT FOUND
Racial/ethnic minority nursing home residents faced poorer end-of-life care than White residents: fewer advance directives and more hospitalizations near death.
Hospice use varied, and Black residents showed more pain in a small study.
Key findings
01Racial/ethnic minority residents were less likely to have advance directives, and White residents were more likely to have do-not-resuscitate or do-not-hospitalize orders.
02Minority residents were more likely to be hospitalized near the end of life, including in the last 90 days before death.
03Hospice use was mixed, with some studies showing lower use among Black residents and others showing higher referral or use among non-White or Hispanic residents.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The included studies were observational, so they describe differences but cannot show cause. Studies varied widely in location, sample size, and how race/ethnicity groups were combined, making broad conclusions difficult. Some studies were small or did not compare cohorts adequately. Only English-language U.S. studies were included.
Declared interests
The supplied publication types indicate NIH extramural support; no author conflict of interest statement is included in the article text.
The easy way to misread this
Do not conclude that any specific intervention reduced disparities. The review describes observational differences in care, not tested treatments, and hospice findings were mixed.