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
JournalJournal of the American Geriatrics Society
Call Numbernewpubs20101112_Willams2.pdf
KeywordsEnd of life decisions, Expectations, Health Conditions and Status, Women and Minorities

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.

Endnote Keywords

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

Endnote ID


Citation Key7114