New Data Shows Which Groups Struggle to Find End-of-Life Care

Credit: Avelino Calvar Martinez, from Burst

In an ideal world, everyone facing their final days would have access to end-of-life care. These services can help alleviate some of the stress associated with such an existential experience. Unfortunately, some groups have struggled more than others to obtain this type essential support.

End-of-Life Care Eludes Opioid Users

End-of-life care disparities remain a global issue, particularly affecting marginalized groups such as people with opioid use disorder (OUD) and cancer patients from minority communities. Research shows that individuals with OUD are less likely to receive timely end-of-life care due to stigma, often resulting in late referrals and emergency interventions.

A Canadian study found that those with OUD are 16% less likely to receive end-of-life care during their last 90 days, and nearly a third of these individuals experience emergency department visits due to their condition. Many of these individuals also come from low-income areas, making them more vulnerable to gaps in care. The study highlights the need for healthcare providers to receive more training in palliative and addiction care, which would enable them to deliver more equitable services.

Most, But Not All, Cancer Patients See More End-of-Life Care

In the U.S., trends in hospice care have shown a growing number of blood cancer patients dying in community settings rather than medical facilities. According to a CDC-based study, nearly 43% of patients with multiple myeloma received care in their homes or at inpatient hospice facilities at the end of life. However, more than half of these patients still die in nursing or medical facilities, although this number is decreasing. The research underscores the importance of caregiver support in determining whether a patient can age and die at home, as well as the influence of race and ethnicity on hospice utilization. Minority groups, including African Americans and Pacific Islanders, use hospice services at lower rates than white patients, pointing to ongoing disparities.

A recent study developed by the National Quality Forum (NQF) and the American Society of Clinical Oncology further examined the cost and effectiveness of aggressive cancer treatments at the end of life. Researchers found that while chemotherapy administered within the last two weeks of life did not improve patient survival rates, it did contribute to higher healthcare costs. This has led experts to advocate for better communication between oncologists and patients about prognosis, allowing for more informed decision-making and potentially reducing unnecessary treatments.

Credit: Burst

Breast cancer patients, in particular, have shown significant benefits from palliative care toward the end of life. A study from Japan found that multidisciplinary palliative treatments, which focus on symptom management rather than radical cures, can improve the quality of life for terminally ill breast cancer patients. This approach involves the use of narcotics, sedation and other interventions to manage pain and alleviate suffering, offering a more compassionate alternative to invasive procedures. The research supports expanding palliative care education to ensure patients receive appropriate and effective end-of-life care.

Overall, these studies highlight the growing recognition of disparities in end-of-life care and the importance of tailored, compassionate approaches to improving quality of life for all patients, particularly those from underserved communities. Addressing these gaps will require a combination of training, systemic changes and better communication between providers and patients.