End-of-Life Experiences Among “Kinless” Older Adults: A Nationwide Register-Based Study
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Date
2023-08-07
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Citation of Original Publication
Mair, Christine A., Lau C. Thygesen, Melissa Aldridge, Djin L. Tay, and Katherine A. Ornstein. “End-of-Life Experiences Among ‘Kinless’ Older Adults: A Nationwide Register-Based Study.” Journal of Palliative Medicine 26, no. 8 (August 2023): 1056–63. https://doi.org/10.1089/jpm.2022.0490.
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This is the accepted version of the following article: Mair, Christine A., Lau C. Thygesen, Melissa Aldridge, Djin L. Tay, and Katherine A. Ornstein. “End-of-Life Experiences Among ‘Kinless’ Older Adults: A Nationwide Register-Based Study.” Journal of Palliative Medicine 26, no. 8 (August 2023): 1056–63. https://doi.org/10.1089/jpm.2022.0490., which has now been formally published in final form at Journal of Palliative Medicine at https://doi.org/10.1089/jpm.2022.0490. This original submission version of the article may be used for non-commercial purposes in accordance with the Mary Ann Liebert, Inc., publishers’ self-archiving terms and conditions.
Subjects
Abstract
Background: The population of older adults who are unpartnered and childless (i.e., “kinless”) is increasing across the globe, and may be at risk for lower quality end-of-life (EoL) experiences due to lack of family support, assistance, and advocacy. Yet, little research exists on the EoL experiences of “kinless” older adults.
Objectives: To document associations between family structure (i.e., presence or absence of partner or child) and intensity of EoL experiences (i.e., visits to medicalized settings before death).
Design: The study design is a cross-sectional population-based register study of the population of Denmark.
Subjects: Participants include all adults age 60 years and older who died of natural causes in Denmark from 2009 to 2016 (n = 137,599 decedents).
Results: “Kinless” older adults (reference = has partner, has child) were the least likely group to visit the hospital (two or more times; odds ratio [OR] = 0.74, confidence interval [CI] = 0.70–0.77), emergency department (one or more times; OR = 0.90, CI = 0.86–0.93), and intensive care unit (one or more times; OR = 0.71, CI = 0.67–0.75) before death.
Conclusions: “Kinless” older adults in Denmark were less likely to experience medically intensive care at the EoL. Further research is needed to understand factors associated with this pattern to ensure that all individuals receive high quality EoL care regardless of their family structure and family tie availability.