Functional impairment, race, and family expectations of death.

TitleFunctional impairment, race, and family expectations of death.
Publication TypeJournal Article
Year of Publication2006
AuthorsWilliams, BA, Lindquist, K, Moody-Ayers, SY, Walter, LC, Covinsky, KE
JournalJ Am Geriatr Soc
Date Published2006 Nov
ISSN Number0002-8614
Call Numbernewpubs20101112_Willams2.pdf
KeywordsActivities of Daily Living, Aged, Attitude to Death, Black or African American, Cross-Sectional Studies, Disabled Persons, Family, Female, Hispanic or Latino, Humans, Male, White People

OBJECTIVES: To assess the effect of functional impairment on family expectations of death and to examine how this association varies by race.

DESIGN: Cross-sectional.

SETTING: Community based.

PARTICIPANTS: Two thousand two hundred thirty-seven family members of decedents from the Health and Retirement Survey (HRS), a national study of persons aged 50 and older.

MEASUREMENTS: Families were interviewed within 2 years of the HRS participant's death. The primary outcome was whether death was expected. The primary predictors were the decedent's functional status (impairment in any activity of daily living (ADL; eating, dressing, transferring, toileting, or bathing) during the last 3 months of life and the decedent's race.

RESULTS: Overall, 58% of families reported that their family member's death was expected. Expecting death was strongly associated with functional impairment; 71% of families of decedents with ADL disability expected death, compared with 24% of those without ADL disability (P < .01). Death was expected more often in families of white decedents (60%) than African Americans (49%) (P < .01), although the effect of ADL disability was similar in both groups. After adjustment for potentially confounding factors, there were still significant associations between expecting death and functional impairment (odds ratio (OR) = 3.58, 95% confidence interval (CI) 2.73-4.70), and families of African Americans expected death less often than families of white decedents (OR = 0.63, 95% CI = 0.46-0.86).

CONCLUSION: Family members of older adults expected death only 58% of the time. Families of functionally impaired older people were more likely to expect death when it occurred than were families of older people who were not functionally impaired, and the expectation of death was lower for families of African Americans than for whites.

User Guide Notes

Endnote Keywords

Activities of Daily Living/Minorities/Hispanic/African Americans/functional impairment/expectations/death

Endnote ID


Alternate JournalJ Am Geriatr Soc
Citation Key7114
PubMed ID17087694
Grant List5 R01 AG023626-02 / AG / NIA NIH HHS / United States
T32-AG00212 / AG / NIA NIH HHS / United States