WHAT IS KNOWN ABOUT HOSPICE ENROLLMENT - FOR NURSING HOME RESIDENTS WITH COGNITIVE DISABILITIES - A SYSTEMATIC REVIEW

Sep 29, 2026

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Background: The number of individuals with cognitive disabilities (CD) receiving hospice care is increasing. Limited knowledge exists about hospice enrollment among nursing home (NH) residents with CDs who die in NHs. Objective: Systematically review evidence on hospice enrollment in NHs for individuals with CDs. Methods: A PRISMA-guided search of U.S., English-language, peer-reviewed literature (PubMed, CINAHL, Web of Science, Google Scholar) through September 20, 2024. Results: From 1,056 screened abstracts, 6 studies met criteria. Significant proportions of CD NH decedents were not enrolled in hospice at death. Factors associated with higher enrollment included female sex, white race, and non-CD terminal diagnosis. Discussion: Dementias were the focus across studies; CD status corresponded to differing hospice enrollment rates. Future research should test interventions to improve enrollment.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Background

Objective

Methods

Search strategy and inclusion criteria

Results

Enrollment patterns and associated factors

Discussion

Future research

Innovation in Aging, 2025, Vol. 9, No. S2 845 Columbia University, New York, New York, United States, 3. Metropolitan Jewish Health System, Inc., New York, New York, United States Background: The population of individuals with cognitive disabilities (CD) accessing hospice care is increasing. CDs are defined as serious difficulty concentrating, remembering, and making decisions, and are often associated with neurocognitive disorders (e.g., dementias and Parkinson’s disease) . Individuals with CDs often live and die in nursing homes (NHs) . Little is known about hospice enrollment for individuals with CDs who die in NHs. Objective: To systematically review the evidence available on hospice enrollment in NHs for individuals with CDs. Methods: Following the PRISMA guidelines, we searched for United States-based, English-language, and peer-reviewed literature on hospice enrollment in NHs for individuals with CDs. PubMed, CINHAL, Web of Science, and Google Scholar were searched for articles published before September 20, 2024. The Joanna Briggs Institute Analytical Cross-Sectional Studies Appraisal Tool to assess study quality. Results: 1,056 titles and abstracts were screened, 22 articles underwent full-text review, and 6 met inclusion criteria. The indicators of CD varied. In all studies, a significant percentage of NH decedents with CDs were not enrolled in hospice at the time of their deaths. Factors associated with increased likelihood of hospice enrollment at the time of death included female sex (n = 2), white race (n = 2), and non-CD terminal diagnosis (n = 1) . Discussion: This systematic review is the first to explore hospice enrollment for NH residents with CDs. All studies focused on individuals with dementias. CD was associated with different rates of hospice enrollment for NH decedents. Future research should aim to explore interventions to improve hospice enrollment for this population. Abstract citation ID: igaf122.2863 WHAT IS KNOWN ABOUT HOSPICE ENROLLMENT FOR NURSING HOME RESIDENTS WITH COGNITIVE DISABILITIES: A SYSTEMATIC REVIEW Victoria Winogora1, Patricia Stone2, Kimberlee Grier2, Lara Dhingra3, and Christine DeForge2, 1. Columbia University School of Nursing, New York, New York, United States, 2.

FAQs

What gap does the systematic review address?

The review targets limited understanding of hospice enrollment among nursing home residents with cognitive disabilities who die in nursing homes.

How were eligible studies selected?

Using PRISMA guidelines, the authors searched U.S.-based, English-language, peer-reviewed literature in PubMed, CINAHL, Web of Science, and Google Scholar through September 20, 2024, then assessed quality with the Joanna Briggs Institute tool.

What factors were linked to higher hospice enrollment at death?

Across included studies, higher enrollment likelihood was associated with female sex, white race, and having a non-CD terminal diagnosis.

Sep 29, 2026

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