Research highlights gender, spousal status

A major national study of gender differences in end-of-life care by the Alliance of Aging Research, in Washington, DC, has highlighted important differences between men and women as they are dying - differences that will challenge the health care system to better meet the needs of dying women. This report, "One Final Gift: Humanizing the End of Life for Women in America," was released at a late April Washington, DC, press conference that featured former first lady Rosalynn Carter and Kathleen M. Foley, MD, director of the New York City-based Project on Death in America.

"Because of the greater survival into very old age by more women, the face of the worldwide longevity revolution is predominantly a female face," the report states. "Wise social planning requires better understanding of the medical and social support needs of the longest-lived, ultimately making way for a humane and life-affirming death at the end of a long life; an end that we would all wish for ourselves and for our loved ones."

The report also identifies some essential truths about women and aging. Women live longer than men, are more likely to suffer from chronic diseases, are more likely to live alone at the end of their lives, are likely to die outside of their homes, and to have unmet care needs. "Society can provide and afford much better care at the end of life that respects women's preferences, provides emotional and physical comfort, fosters family peace and meets spiritual needs," it concludes.

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The health status of a spouse plays an important role in determining when a terminally ill patient seeks hospice care, concludes to a new study by hospice length of stay researcher Nicholas A. Christakis, MD, PhD, MPH, and colleague Theodore J. Iwashyna, AB, of the University of Chicago.

Their article, "Spousal illness burden is associated with delayed use of hospice care in terminally ill patients," appearing in the premier, Spring 1998 issue of the Journal of Palliative Medicine, states that patients with moderately sick or very sick spouses had significantly later enrollment in hospice, compared with those who had healthy spouses. The study was based on a group of 517 couples for whom Medicare health data for both partners was available.

The Journal of Palliative Medicine is published by Mary Ann Liebert of Larchmont, NY, and edited by David E. Weissman, MD, of the Medical College of Wisconsin, in Milwaukee. Its inaugural issue also contains papers on end-of-life care education in home care, a faculty development course in end-of-life care, referrals to a hospice/palliative care consultation service, and specific treatments and symptoms. The journal emphasizes a team approach to end-of-life care.

[Editor's note: To obtain copies of the gender differences report, contact the Alliance for Aging Research, 2021 K St. NW, Suite 305, Washington, DC 20006. Telephone: (202) 293-2856. Fax: (202) 785-8574. For more information on the Journal of Palliative Medicine, contact Mary Ann Liebert, at (914) 834-3100 (within New York State) or (800) 654-3237.]