Journal of the American Medical Directors Association
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Health disparities are pervasive in nursing homes (NHs), but disparities in NH end-of-life (EOL) care (ie, hospital transfers, place of death, hospice use, palliative care, advance care planning) have not been comprehensively synthesized. We aim to identify differences in NH EOL care for racial/ethnic minority residents. ⋯ This review identified NH health disparities in advance care planning, EOL hospitalizations, and pain management for racial/ethnic minority residents. Research is needed that uses recent data, reflective of current NH demographic trends. To help reduce EOL disparities, language services and cultural competency training for staff should be available in NHs with higher proportions of racial/ethnic minorities.
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Review Meta Analysis
Marital Status and Risk of Physical Frailty: A Systematic Review and Meta-analysis.
Evidence on associations between marital status and frailty is limited. The objectives of this study were to perform a systematic review for associations between marital status and physical frailty and to perform a meta-analysis to combine findings. ⋯ Three and 35 studies, respectively, were found providing longitudinal and cross-sectional data regarding associations between marital status and frailty among community-dwelling older people. A meta-analysis of cross-sectional data showed almost twice higher frailty risk in unmarried individuals compared with married individuals. Marital status should be recognized as an important factor, and more longitudinal studies controlling for potential confounding factors are needed.
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Review Meta Analysis
Marital Status and Risk of Physical Frailty: A Systematic Review and Meta-analysis.
Evidence on associations between marital status and frailty is limited. The objectives of this study were to perform a systematic review for associations between marital status and physical frailty and to perform a meta-analysis to combine findings. ⋯ Three and 35 studies, respectively, were found providing longitudinal and cross-sectional data regarding associations between marital status and frailty among community-dwelling older people. A meta-analysis of cross-sectional data showed almost twice higher frailty risk in unmarried individuals compared with married individuals. Marital status should be recognized as an important factor, and more longitudinal studies controlling for potential confounding factors are needed.
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Meta Analysis
Frailty as a Predictor of All-Cause Mortality Among Older Nursing Home Residents: A Systematic Review and Meta-analysis.
We performed a meta-analysis based on prospective cohort studies to synthesize the pooled risk effect and to determine whether frailty is a predictor of all-cause mortality. ⋯ Frailty is a significant predictor of all-cause mortality in older nursing home residents. Therefore, there is an urgent need to screen for frailty in nursing home residents and carry out appropriate multidisciplinary intervention strategies to prevent poor outcomes and reduce the rate of mortality among older nursing home residents.
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Multicenter Study
Association Between End-of-Life Conversations in Nursing Homes and End-of-Life Care Outcomes: A Systematic Review and Meta-analysis.
Less aggressive end-of-life (EOL) care has been observed when health care professionals discuss approaching EOL and preferences about life-sustaining treatments with nursing home (NH) residents or their families. We performed a comprehensive systematic review to evaluate the association between health care professionals-residents and health care professionals-family EOL conversations and EOL care outcomes. ⋯ This systematic review shows that EOL conversations promote palliative care. Structured conversations aimed at exploring NH resident preferences about EOL treatment should become routine. NH administrators should offer health care professionals regular training on EOL conversations, and resident-centered care that involves residents and their families in a shared decision-making process at EOL needs to be promoted.